Format

Send to

Choose Destination
Neuroradiol J. 2015 Apr;28(2):184-6. doi: 10.1177/1971400915576630. Epub 2015 Apr 13.

Reversible and Asymptomatic Gyral and Subarachnoid Contrast Enhancement after Carotid Stenting.

Author information

1
Department of Radiology, University Hospital of Chieti; Chieti, Italy.
2
Department of Radiology, University Hospital of Chieti; Chieti, Italy Department of Neuroscience and Imaging, "G. d'Annunzio" University; Chieti, Italy.
3
Department of Radiology, University Hospital of Chieti; Chieti, Italy Department of Neuroscience and Imaging, "G. d'Annunzio" University; Chieti, Italy caulo@unich.it.

Abstract

The presence of sulcal hyperdensity in patients after endovascular procedures is not necessarily attributable to hemorrhage. It may frequently indicate the absolute or concomitant extravasation of contrast material into the subarachnoid spaces.This case report describes the clinical case of an 84-year-old patient with 90% stenosis of the right internal carotid who presented with a diffuse gyral and sulcal hyperdensity in the right temporal-occipital and frontal lobes at routine post-carotid stenting (CAS) brain CT scan. The patient was asymptomatic and CT findings were interpreted as contrast enhancement hyperattenuation and no therapeutic decisions were made. A 24-hour follow-up brain CT demonstrated the complete resolution of the hyperdensity, confirming the diagnosis.In this patient we considered the concomitant presence of gyral and sulcal hyperdensity as the consequence of reversible damage to the blood-brain barrier (BBB) determining a transitory extravasation of contrast material. Asymptomatic gyral and subarachnoid contrast enhancement following CAS is generally indicative of benign and transitory damage to the BBB and is not to be misinterpreted as hemorrhage.

KEYWORDS:

carotid angioplasty and stenting; contrast extravasation

PMID:
25923674
PMCID:
PMC4757145
DOI:
10.1177/1971400915576630
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center