Terminology

• Contrast bolus in CT scanning: A "contrast bolus" is a small amount of a radio-opaque substance (iodine) which is injected into the bloodstream in order to highlight arteries and veins when examined in a CT scanner. The substance flows through the arteries and veins and then flushes out/rapidly dissipates as the blood flow moves the substance to other parts of the body

• Patent = open, unobstructed, allowing free passage  
  

• MCA = Middle cerebral artery
  

• ICA = Internal carotid artery (http://www.meddean.luc.edu/lumen/meded/neuro/neurovasc/navigation/ica.htm)
  

Description

The video shows a perfusion CT scan of a female patient who had a mild right hemiparesis (weakness on one side of the body). During the course of the scan, she became aphasic and her hemiparesis became much more severe. When the team reviewed the scan, it became clear that an internal carotid artery (ICA) thrombus [clot] became fragmented/dislodged and fragments quickly obstructed the middle cerebral artery (MCA), the anterior cerebral artery, and fetal branches of the posterior cerebral artery. This is the first known video of an ischemic stroke in progress

.mpg version

Reference

Christensen, S., Obi, C., Albers, G., & Lansberg, M. (2015). Ultra-acute CT perfusion imaging: A stroke in the scanner. Neurology, 85, 1725-1726. doi: 10.1212/WNL.0000000000002109

Last updated: Oct. 2, 2016