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. 2023 May 4;23:180. doi: 10.1186/s12883-023-03229-z

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© The Author(s) 2023

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — Cranial imaging appearance of the patients. (A) CT perfusion showed regional hyperperfusion in the left temporal lobe, with characteristics of a significant increase in cerebral blood flow (CBF), a mild increase in cerebral blood volume (CBV), and a prolonged mean transit time (MTT) and time to peak (TTP). (B) Cranial MRI and CT indicated hemorrhagic transformation in the left temporal lobe after intravenous thrombolysis. (C) Cranial CTA showed an early visualized left transverse sinus segment (black arrowhead), which was previously ignored and misinterpreted as venous contamination. (D) Hypervascularity in the left cerebral hemisphere (white arrow) was noted in cranial CTA, consistent with the regional hyperperfusion pattern. (E) Cranial MRI T2 sequence revealed tortuous abnormal vascular flow voids (white arrow) in the left temporo-occipital lobe and cerebellum. (F) Cranial susceptibility-weighted imaging showed clusters of engorgement veins, thought to represent collateral venous flow (white arrow)