Korean J Radiol.  2005 Mar;6(1):41-43. 10.3348/kjr.2005.6.1.41.

Bilateral Paramedian Thalamic Contrast Enhancement on CT after Intra-arterial Thrombolysis

• Yoon W
• Seo JJ
• Kang HK

• KMID: 1783172
• DOI: http://doi.org/10.3348/kjr.2005.6.1.41

Abstract

A 58-year-old woman presented with an acute embolic occlusion of the distal basilar artery. She underwent angioplasty and intra-arterial thrombolysis. Angiography performed after recanalization revealed a single perforating thalamic artery. A nonenhanced CT scan carried out immediately after the procedure revealed hyperdense lesions in the bilateral paramedian portions of the thalami, which disappeared on the 24-hour follow-up CT scan. Three months later, the patient improved to functional independence, but had some memory dysfunction and vertical gaze palsy. This case suggests that contrast enhancement or extravasation can occur in the thalamus after intra-arterial thrombolysis performed to recanalize a basilar artery occlusion.

Keyword

Contrast media; Thalamus; Thrombolysis

MeSH Terms

Angioplasty
Basilar Artery/*radiography
Contrast Media
Female
Humans
Intracranial Embolism and Thrombosis/*radiography/*therapy
Middle Aged
Thalamus/*blood supply
Thrombolytic Therapy
*Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Left vertebral arteriogram (A) shows a complete occlusion of the distal basilar artery. Anteroposterior (B) and lateral (C) views of the angiogram obtained after the angioplasty and intra-arterial thrombolysis procedures demonstrates partial recanalization of the basilar artery and a single perforating thalamic artery (curved arrow) arising from the midline of the basilar bifurcation.

• 

  Fig. 2 A. Nonenhanced CT scan performed immediately after the intraarterial thrombolytic therapy shows hyperdense lesions (arrows) in the bilateral paramedian regions of the thalami. B. The follow-up CT scan obtained 24 hours after completing the intra-arterial thrombolytic procedure shows the disappearance of the hyperdense lesions and the development of hypodensities (arrows) in the bilateral paramedian thalamic regions.

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