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Hemorrhagic Transformation of an Ischemic Infarct - Case 2

A 65 year old man presented with new onset atrial fibrillation and the acute loss of vision to the right. He was put on heparin and four days, he developed headache, nausea and vomiting accompanied by a decreased level of alertness.

Outline the PCA Infarct     Show the Hemorrhagic Transformation at Day 7

Axial CT scans, Day 3: note the well circumscribed hypodensity in the right occipital lobe, corresponding to the distribution of the right posterior cerebral artery. On day 7, note the large hemorrhage in the right occipital lobe, surrounded by some vasogenic edema. In this case, the patient presumably had an embolic infarction from the atrial fibrillation with the embolus occluding the left posterior cerebral artery. In some cases, ischemic infarcts may turn hemorrhagic, with or without anticoagulation, as  it did in this case.

Revised 05/04/06.
The Electronic Curriculum is copyrighted 1998,  Case Western Reserve University School of Medicine.