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What Happened?

Arch Neurol. 2002;59:149-150.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 63-YEAR-OLD woman with a history of lacunar stroke and moderate residual left-sided spastic hemiparesis underwent invasive cardiologic catheterization for evaluation of coronary heart disease. After the procedure, the patient's hemiparesis dramatically worsened, prompting emergency cranial computed tomography (Figure 1), which showed a marked hyperdensity in the right hemiphere.

Figure appears in full text version. Figure 1. Cranial computed tomography scan showing marked hyperdensity in the right hemisphere.

After correct diagnosis and treatment with high fluid intake, the clinical condition rapidly normalized, as did the control computed tomography scan (Figure 2).

Figure appears in full text version. Figure 2. Posttreatment normalized computed tomography scan.

COMMENT

Marked swelling of 1 hemisphere is typically associated with severe cerebral ischemia due to infarction; in particular, space-occupying infarction within the territory of the middle cerebral artery, thrombosis of the cerebral veins, acute hemorrhage, or brain injury. Usually, this condition leads to clinical deterioration, including impairment of consciousness. These dramatic situations could be excluded . . . [Full Text of this Article]