Angiographical extravasation of contrast medium in hemorrhagic infarction. Case report

Leakage of the contrast medium was noted on angiograms of a patient whose autopsied brain disclosed typical pathological findings of hemorrhagic infarction. The case was a 63-year old woman with mitral valve failure, who suddenly had loss of consciousness and right-sided hemiplegia. The left carotid angiography performed six hours after onset demonstrated middle cerebral arterial axis occlusion, and the second angiography performed three days after onset displayed recanalization of the initially occluded artery as well as extravasation of the contrast medium. Fourteen days after onset the patient died and an autopsy was performed. The brain demonstrated perivascular punctate hemorrhages in the area supplied by the middle cerebral artery, and neither hematoma nor microaneurysm was disclosed pathologically. A short discussion is given on the possible relationship between recanalization and hemorrhagic infarction. The clinical assessment of hemorrhagic infarction has not been established successfully.