Teaching NeuroImages Neurology Resident and Fellow Section

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Presentation transcript:

Teaching NeuroImages Neurology Resident and Fellow Section A 38 YEAR OLD MAN WITH RIGHT SIDED WEAKNESS, SENSORYLOSS, & HEMIANOPSIA Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology

VIGNETTE A 38-year old man presented to the emergency department with right sided weakness, sensory loss and hemianopsia. CT and CT Angiogram of the head were performed (Figures 1 and 2) . Capampangan, et al. © 2013 American Academy of Neurology

IMAGING Capampangan, et al. Figure 1 – CT head showing a left hyperdense posterior cerebral artery sign (red arrows). Capampangan, et al. © 2014 American Academy of Neurology

IMAGING Capampangan, et al. Figure 2 – CTA of the head demonstrating occlusion of the left posterior cerebral artery (red arrows). Capampangan, et al. © 2014 American Academy of Neurology

Hyperdense Posterior Cerebral Artery Sign CT head showed a left hyperdense posterior cerebral artery sign (HPCAS) (Figure 1). CT angiogram of the head confirmed a left PCA occlusion (Figure 2). MRI demonstrated a left PCA infarct. Transesophageal echocardiogram revealed an atrial septal aneurysm and patent foramen ovale. He was treated with antiplatelet therapy. The HPCAS has been considered a marker for acute ischemia in the PCA territory. Recognizing the HPCAS on CT in acute stroke may help in the diagnosis and treatment of thromboembolic PCA branch occlusion. References: Krings T, Noelchen D, Mull M, Laus W, Meister IG, Reinacher P, Toepper R, Thron AK. The hyperense posterior cerebral artery sign: a computed tomography marker of acute ischemia in the posterior cerebral artery territory. Stroke 2006, 37:399-403. Capampangan, et al. © 2014 American Academy of Neurology