Dynamic CT perfusion to assess the effect of carotid revascularization in chronic cerebral ischemia

We present the case of a female patient who was studied with dynamic contra st-enhanced CT perfusion before and after carotid revascularization. Before treatment, there was decreased perfusion in the ipsilateral insula, which was shown to be resolved on the scan obtained 1 day after treatment, indica ting the technical success of the revascularization. In the ipsilateral bas al ganglia, there was delayed contrast agent clearance from the tissue, whi ch was attributed to vasodilation; after revascularization, there remained a subtle stenotic effect. The observed changes in the dynamic CT perfusion study suggest that this technique may be a useful tool in the evaluation of patients with asymmetrical cerebral blood flow.