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Thromboembolic Stroke

Sutcliffe JBS - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Brooke Army Medical Center

ABSTRACT

Diagnosis: Thromboembolic Stroke

History: The patient is a resident of an assisted living center who presents to the ED with "global aphasia" of unspecified duration. She has a history of chronic atrial fibrillation and a recent interruption of her prophylactic anticoagulant therapy. A CT scan is obtained which reveals subacute L MCA and L PCA strokes, felt to be secondary to left atrial emboli. She is admitted for supportive treatment. Two days later, during her inpatient stay, she is discovered unresponsive with intact pupils. A repeat CT scan and MRI are immediately obtained.

Findings: Image 1, is a non-contrast CT obtained immediately following her altered mental status on hospital day 3. It reveals hypodensities in the cortical and subjacent white matter regions of the left MCA and left PCA. These findings had been present on HD1 and were felt to represent subacute embolic strokes from cardiac emboli due to a lapse of anticoagulant therapy for her chronic A-fib. Image 2, a diffusion weighted MRI, is obtained shortly after the CT in image 1. It reveals the subacute L MCA stroke, but also reveals an extensive acute R MCA stroke which is not evident on the CT image. This additional stroke is responsible for her acute mental status decline on HD3.

Ddx: Embolic Infarction Thrombotic Infarction Vasculitic Infarction

No MeSH data available.


Diffusion weighted MRI obtained shortly after the CT reveals extensive, acute R MCA infarct which is not evident on the CT image.
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MPX2294_synpic16809: Diffusion weighted MRI obtained shortly after the CT reveals extensive, acute R MCA infarct which is not evident on the CT image.


Thromboembolic Stroke

Sutcliffe JBS - MedPix

Diffusion weighted MRI obtained shortly after the CT reveals extensive, acute R MCA infarct which is not evident on the CT image.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2294&req=5

MPX2294_synpic16809: Diffusion weighted MRI obtained shortly after the CT reveals extensive, acute R MCA infarct which is not evident on the CT image.

View Article: MedPix Image - MedPix Case

Affiliation: Brooke Army Medical Center

ABSTRACT

Diagnosis: Thromboembolic Stroke

History: The patient is a resident of an assisted living center who presents to the ED with "global aphasia" of unspecified duration. She has a history of chronic atrial fibrillation and a recent interruption of her prophylactic anticoagulant therapy. A CT scan is obtained which reveals subacute L MCA and L PCA strokes, felt to be secondary to left atrial emboli. She is admitted for supportive treatment. Two days later, during her inpatient stay, she is discovered unresponsive with intact pupils. A repeat CT scan and MRI are immediately obtained.

Findings: Image 1, is a non-contrast CT obtained immediately following her altered mental status on hospital day 3. It reveals hypodensities in the cortical and subjacent white matter regions of the left MCA and left PCA. These findings had been present on HD1 and were felt to represent subacute embolic strokes from cardiac emboli due to a lapse of anticoagulant therapy for her chronic A-fib. Image 2, a diffusion weighted MRI, is obtained shortly after the CT in image 1. It reveals the subacute L MCA stroke, but also reveals an extensive acute R MCA stroke which is not evident on the CT image. This additional stroke is responsible for her acute mental status decline on HD3.

Ddx: Embolic Infarction Thrombotic Infarction Vasculitic Infarction

No MeSH data available.