Significance of High Density Lesion on Immediate follow-up CT scan after Intraarterial
Thrombolysis for Acute Ischemic Stroke

J Korean Neurol Assoc > Volume 14(1); 1996 > Article

Journal of the Korean Neurological Association 1996;14(1): 53-60.

급성 뇌졸중시 뇌동맥내 혈전용해제주입요법 직후의 뇌전산화 단층촬영상 관찰되는 고음영 소견의 의의

강병수, 이병철, 이혜승, 권기한

한림대학교 의과대학 신경과학교실

Significance of High Density Lesion on Immediate follow-up CT scan after Intraarterial Thrombolysis for Acute Ischemic Stroke

Kyung Soo Kang, M.D., Byung Chul Lee, M.D., Hye Seung Lee, M.D., Ki Han Kwon, M.D.

Department of Neurology Hallym University College of Medicine

Abstract

Background: Although intracranial hemorrhage is a dreadful complication of thrombolytic therapy in acute ischemic stroke, increased densities on immediate CT after intraarterial thrombolytic therapy in some cases, does not have any clinical deterioration and improve dramatically on follow-up CT. This unusual observation inspired us to determine the nature of the lesion of increased density on immediate CT finding, after intraarterial thrombolytic therapy, Subjects and Results; Eight patients presenting with acute middle cerebral artery or internal carotid artery territory strokes were treated by emergency intraarterial urokinase with superselective catheterization. Fight of them had the areas of increased density in the territory sustaining the ischemic event on the immediate CT, performed within 30 minutes after thrombolytic therapy. Most lesions resolved definitely on follow-up scan within 48 hours of their detection. No cases were associated with clinical deterioration. Conclusion; As those lesions were cleared so fast without any clinical deterioration, the area of increased density should not necessarily be interpreted as hemorrhage alone. The density change on immediate CT after intraarterial thrombolysis partially attributable to extravasated pure contrast materials.