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Monday, 26 December 2011

Bilateral Anterior Circulation Stroke

A 70 y o male admitted for stroke evaluation.
Here is MRI Brain diffusion with MR Angio.
MRI Brain Diffusion shows bilateral hemispheric restricted diffusion suggestive of an acute ischemic infarct, involving bilateral peri sylvian cerebral cortex, insular cortex and basal ganglia (bilateral MCA proximal main stem territory), para sagittal fronto parietal cortex (bilateral ACA territories).
Bilateral medial occipital lobes, mesial temporal lobes and thalami (PCA territory) spared.

On Non contrast 3 D TOF brain and 2 D TOF neck angio both the ACAs and MCAs not visualized  Neck angio suboptimal as pt was non coperative.

Diagnosis : Anterior circulation stroke - Simultaneous bilateral hemispheric infarcts / Bilateral ACA - MCA territory. 
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2 comments:

  1. Karunakaran M5 January 2012 at 17:48

    What a coincidence, I too got to see a similar patient this week....

    The natural history of any disease is that it is based on the rapidity with which the disease progressess... we see patients walking normally with carotid occlusions... some in horrible scenario with small infartcs... wonder how the disease mechanisms plays with us... !!!

    nice post Balaji !!!

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    ReplyDelete