Stroke, Ischemic
As the saying goes: "time is brain."
Cases
1
This patient presented with right hemiparesis and aphasia. A CTA revealed a left M2 occlusion. What this image shows is how collaterals came to the rescue. The patient subsequently underwent a successful mechanical thrombectomy with TICI 2C reperfusion.
- Pink arrow: patent superior M2.
- Teal arrow: impeded flow in one of the branches of the inferior M2, suggesting distal occlusion.
- White arrow: complete occlusion of one of the branches of the inferior M2.
- Blue arrow: one collateral originating from the right ACA.
- Green arrow: another collateral originating from the right ACA.
- Yellow arrow: a collateral from the PCA.
- Red arrow: another collateral from the PCA.
2
This patient underwent DSA for the treatment of intracranial vasospasm.
(A): Posterior circulation run showed collateral flow to an ACA branch (red arrow).
(B): Left ICA injection showed severe left A1 (orange arrow) vasospasm, explaining the presentation seen in (A).
(C): This same ACA branch (red arrow) could be faintly seen on the lateral run of the left ICA injection.
3
This patient presented with left hemiparesis and a stroke alert was activated. CTA head and neck showed an aortic dissection, complete occlusion of the brachiocephalic artery origin, and partial occlusion of the left CCA origin.