Hyperdense posterior cerebral artery sign in a setting of spontaneous vertebral artery dissection: A blessing in disguise?

Sankalp Gokhale, Carmelo Graffagnino

Research output: Contribution to journalArticle

Abstract

Objective: To report a case of a hyperdense posterior cerebral artery (PCA) sign in the setting of spontaneous vertebral artery dissection. Clinical Presentation and Intervention: A 28-year-old, previously healthy female presented with rapidly progressive coma. A noncontrast computerized tomographic (CT) scan showed a hyperdense PCA sign, which prompted an urgent arteriogram. She was found to have spontaneous vertebral artery dissection with an occluding thrombus. She underwent intra-arterial thrombolysis with tissue plasminogen activator. Follow-up magnetic resonance imaging showed an area of acute infarction in the medial temporal and occipital regions corresponding to the area supplied by the left PCA. The patient was started on systemic anticoagulation therapy with intravenous heparin. She showed slow and continued recovery but was left with significant neurological deficits that required posthospital discharge to a long-term rehabilitation facility. Conclusion: This case showed that the hyperdense PCA sign on a noncontrast CT scan necessitated an emergent CT angiogram that showed vertebral artery dissection and a devastating vascular occlusion. Hence, we suggest an early intervention that may allow for potential revascularization therapy.

Original languageEnglish (US)
Pages (from-to)86-88
Number of pages3
JournalMedical Principles and Practice
Volume23
Issue number1
DOIs
StatePublished - Dec 2013

Fingerprint

Vertebral Artery Dissection
Posterior Cerebral Artery
Occipital Lobe
Tissue Plasminogen Activator
Temporal Lobe
Coma
Infarction
Blood Vessels
Heparin
Angiography
Thrombosis
Rehabilitation
Magnetic Resonance Imaging
Therapeutics

Keywords

  • Dissection
  • Hyperdense posterior cerebral artery

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hyperdense posterior cerebral artery sign in a setting of spontaneous vertebral artery dissection : A blessing in disguise? / Gokhale, Sankalp; Graffagnino, Carmelo.

In: Medical Principles and Practice, Vol. 23, No. 1, 12.2013, p. 86-88.

Research output: Contribution to journalArticle

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