Hemorrhage or Ischemia? The Importance of ‘Spotting’ it Right

Background A 78-year-old woman was transferred directly to an ICU because of intracerebral hemorrhage. However, on careful review of the initial imaging, the likely diagnosis was ischemic stroke and reperfusion hemorrhage. Methods Case report was explained. Results The patient suffered significant r...

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Bibliographic Details
Published in:Neurocritical care 2015-08, Vol.23 (1), p.113-115
Main Authors: Scharf, E. L., Kramer, C. L., Rabinstein, A. A.
Format: Article
Language:English
Subjects:
Aged
Blood clots
Blood pressure
Brain Ischemia - diagnostic imaging
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - etiology
Critical Care Medicine
Edema
Emergency medical care
Female
Hematoma
Hemorrhage
Humans
Hypertension
Intensive
Internal Medicine
Ischemia
Laparoscopy
Medical imaging
Medicine
Medicine & Public Health
Neurology
Patients
Practical Pearl
Radiography
Reperfusion Injury - complications
Reperfusion Injury - diagnostic imaging
Stroke
Stroke - complications
Stroke - diagnostic imaging
Surgery
Tomography
Veins & arteries
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Description
Summary:Background A 78-year-old woman was transferred directly to an ICU because of intracerebral hemorrhage. However, on careful review of the initial imaging, the likely diagnosis was ischemic stroke and reperfusion hemorrhage. Methods Case report was explained. Results The patient suffered significant reperfusion hemorrhage. A CT angiogram revealed contrast extravasation “spot sign” in the bed of the expanding hemorrhage and an occlusive thromboembolism distal to the initial ischemic insult. Conclusion In this case of embolic ischemic stroke with reperfusion hemorrhage, contrast extravasation “spot sign” was associated with hematoma expansion.
ISSN:1541-6933
1556-0961
DOI:10.1007/s12028-015-0113-1