case_images: PMC10963473_01
case_images: (I) CT angiography did not reveal any signs of cerebral hemorrhage or large vessel occlusion. (II) MRI showed multiple intracranial demyelination lesions and infarction only in the right temporal lobe and posterior horn of the ventricle. (III) MRI showed improvement in the intracranial demyelination lesions and a new IS in the left external capsule. (IV) CT scan indicated a HS of approximately 66 mL which was absorbed within 33 days after the operation.
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case_images: Her initial National Institute of Health Stroke Scale (NIHSS) score was 13. Head and neck computed tomography(CT) angiography did not show any signs of cerebral hemorrhage or large vessel occlusion (Figure 1I). Brain magnetic resonance imaging(MRI) performed 24 h after thrombolysis showed infarction only in the right temporal lobe and posterior horn of the ventricle (Figure 1II). Notably, brain MRI conducted on the 20th day after admission revealed a new IS (Figure 1III). A brain CT scan indicated a HS of approximately 66 mL, which required an urgent craniotomy (Figure 1IV).
case_images: HE staining showed chronic inflammatory cells in the vicinity of the blood vessels. Immunohistochemical analysis demonstrated the infiltration of CD4+ and CD8+ T lymphocytes around the blood vessels. The yellow arrow indicates the presence of either CD4+ or CD8+ cells
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case_images: Immunohistochemical analysis of the hematoma sample collected during the operation revealed CD4+ and C8+ T lymphocytes surrounding the blood vessels (Figure 2).
case_images: Timeline.
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case_images: The patient had regained the ability to walk and had a modified Rankin Scale (mRS) score of 2, although she still experienced incoherent speech (Figure 3).