Confounding Imaging Findings in Subacute-Chronic Cerebral Infarction

Special Article - Cerebral Infarction

Austin J Cerebrovasc Dis & Stroke. 2017; 4(3): 1063.

Confounding Imaging Findings in Subacute-Chronic Cerebral Infarction

Hernández-Díaz ZM*, Barroso-García E, González-García S, González-Quevedo A, Reyes- Berazaín A and Arteche-Prior M

Department of Neuroimagenology, Institute of Neurology and Neurosurgery, Cuba

*Corresponding author: Hernández-Díaz ZM, Institute of Neurology and Neurosurgery, Calle 29 y Esquina D La Habana, Cuba

Received: May 10, 2017; Accepted: June 02, 2017; Published: June 21, 2017

Abstract

Imaging findings which appear during the course of subacute and chronic cerebral infarct and which can lead to confusion for diagnosis is presented in a series of six patients. These include: luxury perfusion, fogging effect, hemorrhagic transformation, Wallerian degeneration, diaschisis, laminar cortical necrosis and encephalomalacia with exvacuum dilation.

Keywords: Subacute infarct; Chronic infarct; Luxury perfusion; Fogging effect; Hemorrhagic transformation; Wallerian degeneration; Diaschisis; Laminar cortical necrosis; Laminar cortical necrosis encephalomalacia; Exvacuum dilation

Abbreviations

MCA: Medial Cerebral Artery; ACA: Anterior Cerebral Artery; WD: Wallerian Degeneration; CT: Computerized Tomography; MRI: Magnetic Resonance Imaging; FLAIR: Fluid Attenuated Inversion Recovery; CBF: Cerebral Blood Flow; SPECT: Single-Photon Emission Computed Tomography

Introduction

After occlusion of a cerebral artery, imaging studies confirm cerebral infarction during hyper acute and acute phases [1-3]. This allows engaging in therapeutic decisions with the aim of reducing damaged tissue and thus the subsequent sequels.

Nevertheless, imaging findings can occur during subacute and chronic phases of cerebral infarction that could disguise or mimic other neurological processes. Although these findings have been described in the literature, in many occasions they are overlooked and can originate confusion when conducting imaging diagnosis. Among these are: luxury perfusion, fogging effect, hemorrhagic transformation, Wallerian degeneration, diaschisis, laminar cortical necrosis and encefalomalacia with exvacuum dilation [4-9].

During the subacute-chronic phase of cerebral infarction, many physicians can inform the images as negative and may even not associate these imaging findings with primary ischemic damage, interpreting them as independent events, thus modifying the diagnosis

The object of this work was to describe the occurrence of these imaging findings in a series of six patients with cerebral infarction during the subacute-chronic phase. The description of the subjects is represented in Table 1.