J Korean Neurol Assoc.  1996 Mar;14(1):53-60.

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

• Kang KS
• Lee BC
• Lee HS
• Kwon KH

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.

MeSH Terms

Carotid Artery, Internal
Catheterization
Catheters
Contrast Media
Emergencies
Follow-Up Studies*
Hemorrhage
Humans
Intracranial Hemorrhages
Middle Cerebral Artery
Stroke*
Thrombolytic Therapy
Tomography, X-Ray Computed*
Urokinase-Type Plasminogen Activator
Contrast Media
Urokinase-Type Plasminogen Activator