Figure 1

CT perfusion-guided endovascular treatment of symptomatic cerebral vasospasm in a patient with perimesencephalic non-aneurysmal subarachnoid hemorrhage

Andrea Saletti*, Andrea Bernardoni, Luca Borgatti1, Giuseppe Carità, Marco Farneti, Onofrio Marcello and Enrico Fainardi

Published: 31 March, 2020 | Volume 4 - Issue 1 | Pages: 020-021


Figure 1:

Figure A-H: Standard CT scan and cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) CTP maps obtained 11 days after admission at the level of basal ganglia (A-D) and lateral ventricles (E-H) and showing reduced CBF, increased MTT and normal CBV in the left middle cerebral artery (MCA) territory, in absence of focal areas of hypoattenuation. Figure I-L: the following cerebral digital subtraction angiography (DSA) demonstrating a severe vasospasm in sovraclinoid segment of both internal carotid artery and in the M1 segment of left MCA (I-J) and its partial remission observed after the intra-arterial injection of nimodipine (K-L). Figure M-P: cerebral DSA performed 12 days after entry and illustrating the recrudescence of vasospasm (M), its initial improvement after nimodipine intra-arterial administration (N), balloon positioning in the left MCA (O) and the final resolution of arterial narrowing (P). Figure Q-X: Standard CT scan and CBF, CBV and MTT CTP maps acquired 13 days after admission at the level of basal ganglia (Q-T) and lateral ventricles (U-X) and documenting the complete restoring of cerebral perfusion in the left MCA territory.

Read Full Article HTML DOI: 10.29328/journal.acr.1001033 Cite this Article Read Full Article PDF

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