Intracranial contrast enhancement was misdiagnosed as cerebral hemorrhage after cerebral arterial thrombolysis and literature review

doi:10.3877/cma.j.issn.2095-655X.2014.01.004

Abstract

Abstract:

Objective

To study the causes of high density focus in brain after intracranial arterial thrombolysis, and improve the identification of the intracranial contrast enhancement, cerebral hemorrhage conversion and reduce misdiagnosis.

Methods

The CT scan in carotid artery stenting of the patient artery stenting who with severe stenosis of internal carotid artery was retrospective analysis.

Results

Anterior and middle cerebral artery occlusion were found in the surgery.CT scan showed high density focus in left basal ganglia after arterial thrombolysis, and dynamic CT scan of brain was given after 72 hours.The intracranial high density lesions disappeared after 72 hours.And after the surgery cerebral hemorrhage was excluded and the contrast enhancement was considered.

Conclusions

The intracranial contrast enhancementartery in patients with cerebral infarction can be found frequently, and confused with cerebral hemorrhage.We should improve the understanding and give patients active treatment.

Key words: Thrombolytic therapy, Cerebral hemorrhage, Contrast media

Shen Yang, Li Zhang, Hongjun Li, Lichen Qin, Yunlin Liu. Intracranial contrast enhancement was misdiagnosed as cerebral hemorrhage after cerebral arterial thrombolysis and literature review[J]. Chinese Journal of Diagnostics(Electronic Edition), 2014, 02(01): 24-26.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhzdxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-655X.2014.01.004

https://zhzdxdzzz.cma-cmc.com.cn/EN/Y2014/V02/I01/24

Figures/Tables 1

References 7

[1]	Bourekas EC,Slivka AP,Shah R, et a1.Intraarterial thrombolytic therapy within 3 hours of the on set of stroke[J]. Neurosurgery, 2004, 54(1): 39-44.
[2]	杨志寅. 现代医学科学发展中的缺憾与思考[J]. 中华诊断学电子杂志, 2013, 1(1): 1-7.
[3]	Lylyk P,Cohen JE,Ceratto R, et al. Angioplasty and stent placement in intracranial atherosclerotic stenoses and dissections[J]. AJNR Am J Neuroradilol, 2002, 23(3): 430-436.
[4]	Khatri P,Broderick JP,Khoury JC, et al.Microcatheter contrast Injections during Intra-arterial thrombolysis may increase intracranial hemorrhage risk[J]. Stroke, 2008, 39(12): 3283-3287.
[5]	Ouriel K,Shortell CK,Illig KA, et al.Intracerebral hemorrhage after carotid endarterectomy：incidence, contribution to neurologic morbidity, and predictive factors[J]. J Vasc Surg, 1999, 29(1): 82-87.
[6]	Yokogami K,Nakano S,Ohta H, et al.Prediction of hemorrhagic complications after thrombolytic therapy for middle cerebral artery occlusion：value of pre-and post-therapeutic computed tomographic findings and angiographic occlusive site[J]. Neurosurgery, 1996, 39(6): 1102-1107.
[7]	周龙江,王苇,张新江, 等. 颅内介入术后即刻头颅CT高密度影像分析[J]. 放射学实践2010, 25(6): 612-615.

[1]	Ultrasound Committee of Chinese Research Hospital Association, Ultrasound Branch of Chinese Medical Doctor Association, Ultrasound Branch of Chinese Medical Imaging Technology Research Association, Beijing Ultrasound Medical Association. Expert consensus on standardized nursing of contrast enhanced ultrasound [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(06): 489-498.
[2]	Zhongman Zhang, Yi Zhu, Wei Li, Di An, Yue Zou, Yu Xia, Tao Ding, Yutong Shi, Xufeng Chen. Risk factors of intracerebral hemorrhage in patients with extracorporeal membrane oxygenation [J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2022, 15(06): 454-459.
[3]	Changlin Xu, Hao Cheng, Congguo Liu, Yun Gao, Yi Li, Yuanyuan Qiao, Sheng Chen. Comparative analysis of the effects of ROSA localized burr hole hematoma removal and empirical localized burr hole hematoma removal in the treatment of spontaneous intracerebral hemorrhage [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2023, 09(02): 97-101.
[4]	Zhengwen Diao, Yuchang Xu, Jie Zhang, Huajun Zhang, Qiulin Li, Hui Chen. Clinical analysis of β-aescinate sodium combined with glycerin fructose in the treatment of cerebral hemorrhage [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2023, 09(01): 32-37.
[5]	Zhihui Tang, Wei Huang, Fei Luo, Wenhao Wang. Analysis of epidemiological characteristics and mortality factors of patients with spontaneous intracerebral hemorrhage [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(04): 224-228.
[6]	Bin Sun, Zongzhao He, Hao Wang, Ting Wang, Xiaoqin Liu. A study on the correlation between the severity and inflammatory response of hypertensive intracerebral hemorrhage patients undergoing surgery in the Xining area [J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2023, 09(01): 62-68.
[7]	Yong Zou, Yingjiang Gu, Hao Ding, Chenghao Yang, Minhui Chen, Yu Cai. Effects of puerarin on early inflammatory and oxidative stress responses involving the Nrf2/HO-1 and NF-κB signaling pathways after intracerebral hemorrhage in rat models [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(05): 271-277.
[8]	Mo Yun, Maofang Li, Hao Wang, Dongyuan Liu. Clinical study of minimally invasive puncture and drainage combined with piracetam and urapidil in the treatment of hypertensive intracerebral hemorrhage in basal ganglia [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(05): 278-285.
[9]	Zhengwei Liu, Lizhi Yi, Xilong Yin, Wenlong Kong, Zhisong Jiu, Wenyuan Zhang. Efficacy analysis of external drainage of conocephalic hematoma and neuroendoscopic surgery for senile hypertensive intracerebral hemorrhage in basal ganglia [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(05): 299-303.
[10]	Xianjin Chen, Qinqin Wu, Changchun He, Qinghua Zhang. Research on constructing prognosis prediction model of intracerebral hemorrhage using multimodal medical data and machine learning [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(04): 193-198.
[11]	Ke Tan, Jinping Li, Yutao Peng, Wenqian Wu, Ziwen Yang, Yang Wang, Libo Tao, Chang Liu. Efficacy and health economic evaluation of robot-assisted stereotactic hematoma drainage for spontaneous intracerebral hemorrhage [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(04): 205-214.
[12]	Yongsheng Meng, Rong Yong, Xiaoli Ji, Yulong Zhao, Pengfei Zhao. Preventive effect of dexmedetomidine combined with sevoflurane on secondary injury after intracerebral hemorrhage and its neuroprotective mechanism [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(01): 44-50.
[13]	Jing Ding, Peiwen Li, Yingchun Xu. The application of Xingnao Kaiqiao acupuncture in severe neurological emergencies [J]. Chinese Journal of Acupuncture and Moxibustion(Electronic Edition), 2023, 12(04): 161-164.
[14]	Tun Zhao, Jihua Xu, Youdi He, Ming Lu. Acute spontaneous trace amount cerebral hemorrhage misdiagnosed as cerebral infarction and nearly thrombolysis: a case report [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2023, 17(04): 369-372.
[15]	Ping Hu, Tengfeng Yan, Haizhu Zhou, Xingen Zhu. Advances in artificial intelligence be applied to early diagnose intracranial hemorrhage and hematoma segmentation [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2023, 17(04): 410-416.

Please choose a citation manager

Content to export