Beginning hypodensity and mass effect in the left MCA territory (a–c). The hypodensity corresponds to more than 33% of the territory. After thrombolysis, the next day there is massive hemispheric bleeding and brain herniation (d–f)
When this early hypodensity is visible in more than 30% of the
affected MCA territory, there is an increased risk of secondary
bleeding if thrombolysis is started; this was an important finding
of the ECAS study [ 25 , 26 ] (Fig. 9 ) ..
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