Abstract

PBV delineates the whole volume of cerebral infarction in hyperacute phase

posted by Harald Seifarth, M.D. | Nov 16, 2007

Case History

An 80-year-old male patient is presenting with left sided hemiparesis and neglect; onset 2 hours ago

Questions

Exclusion of intracerebral hemorrhage. Demarcation of ischemic brain tissue, location and extent of cerebral infarction

Diagnosis / Differential diagnosis

The patient suffered from a right sided ischemic infarction following thrombembolic occlusion of a M2 branch of the middle cerebral artery. In addition frontotemporal atrophy is present.

Findings

Slight fading of the basal ganglia on the right side. Note the hyperdense MCA branches in the insular cistern on the right. The CTA shows a proximal M2 branch occlusion. PCT shows a perfusion deficit in the frontotemporal parenchyma and the insular ribbon on the right side. The whole extent of the perfusion deficit can be seen on reformations of the PBV data.

Comments

PBV depicts the perfusion deficit correlating to the CBV in axial slices in the hyperacute phase of an ischemic infarction. The three dimensional extent of the perfusion deficit can be seen in sagittal and coronal reformation of the PBV dataset.

[1]: NECT Image	[2]: MIP reformation of CTA
[3]: PCT images: CBF (upper left), CBV (upper right) and time to peak (TTP)	[4]: Reformations of PBV dataset: axial (upper left), coronal (upper right) and parasagittal