Related Experiment Video
Updated: Feb 25, 2026
13:10
Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
Published on: September 25, 2016
10.4K
Infarct fogging on immediate postinterventional CT-a not infrequent occurrence.
Sven Dekeyzer1,2, Arno Reich3, Ahmed E Othman4
1Department of Medical Imaging, Onze-Lieve-Vrouw (OLV) Ziekenhuis Aalst, Moorselbaan 164, 9300, Aalst, Belgium. Sven.Dekeyzer@gmail.com.
Neuroradiology
|August 5, 2017
Summary
Pseudo-normalization of brain infarcts after endovascular stroke treatment (EST) is common. This imaging finding, likely due to contrast leakage, does not indicate successful salvage of brain tissue.
Area of Science:
- Neuroradiology
- Neuroimaging
- Stroke Imaging
Background:
- Post-endovascular stroke treatment (EST) CT scans can show a "fogging effect" or pseudo-normalization of infarcted brain parenchyma.
- This phenomenon, typically seen weeks after stroke, can appear immediately post-EST.
Purpose of the Study:
- To determine the incidence of immediate post-EST pseudo-normalization.
- To analyze the evolution of this imaging finding on follow-up scans.
Main Methods:
- Retrospective analysis of 152 patients treated for acute anterior circulation stroke between 2010-2015.
- Inclusion criteria: ASPECT-score < 10, post-interventional CT within 4.5 hours.
- Two independent reviewers analyzed pre- and post-interventional CT scans.
Main Results:
- Pseudo-normalization (hypodense to isodense) occurred in 37 patients (49 ASPECTS areas).
- In 20 patients (13%), isodense areas were indistinguishable from normal parenchyma.
- Follow-up imaging confirmed infarction in all isodense areas.
Conclusions:
- Immediate pseudo-normalization of infarcts after EST is a frequent observation.
- The most probable cause is contrast leakage into the infarcted tissue.
- This finding does not represent successful reperfusion or salvage of brain parenchyma.
