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Fig. 1 | BMC Neurology

Fig. 1

From: A case report of delayed cortical infarction adjacent to sulcal clots after traumatic subarachnoid hemorrhage in the absence of proximal vasospasm

Fig. 1

Development of a cortical infarct around sulci filled with subarachnoid blood. (a) is a representative image of the initial CT scan on day 0. It shows subarachnoid blood in two sulci of the left frontal cortex (arrow). In addition, a left-sided hematoma exterior of the head marks the area of the impact. (b) Whereas the subsequent CT scans on days 1, 3, 5 and 9 showed no new infarcts, the follow-up CT scan on day 14 revealed a new hypodensity confined to the cortical gray matter around the sulci that had shown subarachnoid blood in the CT scan on day 0. This lesion was consistent with the new infarct seen on the MRI scan of day 10. (c) The T2* weighted image of the MRI on day 10 revealed that the subarachnoid blood was still present in the sulci in which it had been seen on the initial CT scan, although the hyperdensity had disappeared on later CT scans. (d) The DWI on day 10 showed a hyperintensity typical of a new infarct around the sulci with subarachnoid blood. This DWI hyperintensity corresponded to an ADC reduction (not shown). The synopsis of images (a) – (d) provides evidence for delayed cortical laminar necrosis adjacent to the sulcal clot in the left frontal cortex. (e) The MRA on day 10 and (f) the CTA on day 14 did not show any evidence of proximal vasospasm

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