Contrast staining post endovascular clot retrieval

Case contributed by Dr Henry Knipe

Presentation

Left hemiparesis.

Patient Data

Age: 65 years
Gender: Male
Hyperdensity to the right caudate nucleus body and lentiform nucleus is compatible with contrast staining given history. No acute intracranial haemorrhage identified. Grey-white differentiation is preserved. Ventricular size, sulcal pattern and basal cisterns are normal for age. No significant mass effect. No midline shift.
CT

24 hours later

Previously demonstrated hyperdensity of the right caudate body and lentiform nucleus likely related to contrast and has now significantly reduced. No convincing region of established cortical infarct identified. No acute intracranial haemorrhage or extra-axial collection. Ventricles are stable. No midline shift.

Case Discussion

Contrast staining typically appears as areas of hyperdensity mostly confined to grey matter (cortex and deep grey matter) and represent areas of blood-brain barrier breakdown secondary to ischaemia with microvascular extravasation of contrast into the extracellular space. Typically such staining clears within the first 19-24 hours after the procedure. 

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Case information

rID: 57239
Published: 11th Jan 2018
Last edited: 16th Jul 2018
Tag: stroke, ecr
Inclusion in quiz mode: Included

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