case_images: PMC8412819_01
case_images: Non contrasted CT (A) and CT-Angiography (B) show a proximal occlusion of the right posterior cerebral artery (PCA) at P1-P2 junction (arrow) without signs for acute ischemic stroke or hemorrhage.
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case_images: Accordingly, urgent cerebral CT and CT-angiography (Figure 1) were done, which showed a proximal occlusion of the right posterior cerebral artery (PCA) at the P1-P2 junction without signs of established acute ischemic stroke or hemorrhage.
case_images: Digital subtraction angiography (A) before thrombectomy shows right P1-P2 occlusion (arrow), and (B) after thrombectomy shows near complete perfusion with TICI 2b.
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case_images: Thrombolysis in cerebral infarction (TICI) 2b was achieved as shown in (Figure 2).
case_images: CT follow up 24 hours after acute reperfusion therapies shows acute ischemic stroke in right PCA territory with substantial hemorrhagic transformation (arrow).
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case_images: The follow-up CT (Figure 3) revealed an acute large ischemic stroke in the whole territory of a right posterior cerebral artery (PCA) up to the thalamus with substantial hemorrhagic transformation in the shape of parenchymal hematoma type 1 (PH1).
case_images: Axial brain MRI images of diffusion-weighted imaging (A), apparent diffusion coefficient (B), and susceptibility-weighted imaging (C) sequences, show acute ischemic changes in the right PCA territory with hemorrhagic transformation.
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case_images: The patient was also taken for a magnetic resonance imaging (MRI) scan, which did not reveal any new findings (Figure 4).