title: Massive cortico-subcortical ischemic stroke with a consecutive hemorrhagic event: a case report.
abstract: BACKGROUND
  We report a case of a 78-year-old woman with a large cerebral infarction probably due to athermanous embolism following atrial fibrillation.
  
  
  METHODS
  The patient, known with atrial fibrillation, high blood pressure and heart failure, complained of headache and motor impairment on the left side of the body. CT imaging revealed a subacute ischemic lesion in the right fronto-occipital lobes, and an old ischemic lesion in the right fronto-parietal lobes. Anticoagulant treatment was conducted with careful monitoring of the coagulability status. After almost three weeks, suddenly the patient became comatose and died shortly after. Macroscopic and microscopic examination confirmed the cortico-subcortical ischemic lesions, but also identified a fresh hemorrhagic site in pons, distant from the initial lesion sites. An immunohistochemical study identified blood vessels in the ischemic sites completely isolated from any glial support.
  
  
  CONCLUSIONS
  This is a rare case of a large cerebral infarction with a pontine hemorrhagic event.
authors.affiliation: Department of Histology, University of Medicine and Pharmacy of Craiova, Romania. daniel.pirici@webmail.umfcv.ro
authors.forename: D
authors.initials: D
authors.lastname: Pirici
authors.forename: Daniela Adriana
authors.initials: DA
authors.lastname: Ion
authors.forename: L
authors.initials: L
authors.lastname: Mogoantă
authors.forename: Otilia
authors.initials: O
authors.lastname: Mărgăritescu
authors.forename: Ionica
authors.initials: I
authors.lastname: Pirici
authors.forename: Camelia
authors.initials: C
authors.lastname: Foarfă
authors.forename: Valerica
authors.initials: V
authors.lastname: Tudorică
authors.forename: N M
authors.initials: NM
authors.lastname: Panduru
authors.forename: Marieta
authors.initials: M
authors.lastname: Coconu
authors.forename: I A
authors.initials: IA
authors.lastname: Checheriţă
mesh_terms: D000368:Aged; D001253:Astrocytes / Q000378:metabolism / Q000473:pathology; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D002544:Cerebral Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D005904:Glial Fibrillary Acidic Protein