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Updated: Jul 28, 2026
09:11
Embolic Middle Cerebral Artery Occlusion (MCAO) for Ischemic Stroke with Homologous Blood Clots in Rats
Published on: September 17, 2014
Massive cerebral edema after recanalization post-thrombolysis
S Cruz-Flores1, D W Thompson, J R Boiser
1Souers Stroke Institute, Department of Neurology, Saint Louis University Health Sciences Center, 3635 Vista Avenue, St. Louis, MO, USA. cruz-fls@slucare1.sluh.edu
Summary
Intra-arterial thrombolysis for acute ischemic stroke can cause brain swelling. This case shows that massive cerebral edema after reperfusion can occur with a good clinical outcome.
Area of Science:
- Neurology
- Interventional Neurology
- Stroke Medicine
Background:
- Intravenous thrombolysis is a standard treatment for acute ischemic stroke within 3 hours.
- Potential complications include hemorrhage and postrecanalization cerebral edema.
- Intra-arterial thrombolysis offers an alternative treatment option.
Observation:
- An 81-year-old male presented with acute ischemic stroke in the right middle cerebral artery (MCA) territory.
- Successful intra-arterial urokinase treatment resulted in immediate clinical improvement.
- Serial CT scans revealed massive cerebral edema in the MCA distribution despite clinical recovery.
Findings:
- Postrecanalization cerebral edema is a rare but serious complication of thrombolysis.
- The edema is hypothesized to result from reperfusion injury.
- This case demonstrates that massive edema can occur even with a favorable clinical outcome.
Implications:
- Clinicians should be aware of the possibility of postrecanalization cerebral edema.
- This complication does not always correlate with a poor prognosis.
- Further research is needed to understand and manage this phenomenon.
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