Apparent reversal of early ischemic changes on non-contrast computed tomography following successful endovascular reperfusion

Stroke Vasc Interv Neurol. 2022 Jul;2(4):e000197. doi: 10.1161/svin.121.000197. Epub 2022 Feb 23.

Abstract

Early ischemic changes seen on Non-contrast computed tomography (NCCT) secondary to cerebral edema is believed to indicate irreversible cellular injury. Computed tomography perfusion (CTP) may overpredict the infarct core in patients with large vessel occlusion (LVO) presenting in acute phase as these changes are potentially reversible if successful endovascular reperfusion is performed in a timely manner. This has led to the concept of "ghost infarct core" which is the mismatch in the infarct core as seen on follow-up imaging. We present a case which potentially supports the concept of "ghost infarct core" evaluated not only by CTP but also NCCT in a patient with LVO following successful thrombectomy.