case_images: PMC4910610_01
case_images: Neuroimaging in the emergency department. Notes: (A) CT brain scan shows the absence of hemorrhage or previous ischemic brain lesions. (B) CT angiography demonstrating normal contrast filling of the intracranial vessels.. Abbreviation: CT, computerized tomography.
case_images: imcrj-9-145Fig1.jpg
case_images: PMC4910610_01_imcrj-9-145Fig1.jpg
case_images: f1-imcrj-9-145
case_images: No acute or chronic lesions were present in the brain computerized tomography (CT) (Figure 1A). CT angiography did not reveal any evident thrombus in proximal intracranial vessels (Figure 1B).
case_images: CT perfusion scan during the acute phase.. Notes: No asymmetries between both hemispheres are present in the cerebral blood flow (A), volume (B), or mean transit time (C) sequences.. Abbreviation: CT, computerized tomography.
case_images: imcrj-9-145Fig2.jpg
case_images: PMC4910610_01_imcrj-9-145Fig2.jpg
case_images: f2-imcrj-9-145
case_images: Perfusion CT showed no volume or medium transit time alterations (Figure 2).
case_images: Post-thrombolysis 3T MRI.. Notes: (A) DWI-MRI sequence shows the absence of acute damage to the brain. (B) T1-weighted MRI sequences demonstrate the presence of a small acute subarachnoid hemorrhage in the right occipital lobe (arrow), not present in the emergency CT scan upon admission (C).. Abbreviations: DWI-MRI, diffusion-weighted imaging MRI; MRI, magnetic resonance imaging; CT, computerized tomography; 3T MRI, 3 tesla resolution magnetic resonance imaging..
case_images: imcrj-9-145Fig3.jpg
case_images: PMC4910610_01_imcrj-9-145Fig3.jpg
case_images: f3-imcrj-9-145
case_images: A second CT scan 24 hours after treatment with tPA was normal, but later brain magnetic resonance imaging (MRI) showed a convexal subarachnoid hemorrhage in the right occipital lobe, not present in the previous images, inconsistent with the initial symptoms and that went clinically unnoticed (Figure 3).