Article Figures & Data
Figures
- Fig 1.
Case 4. A 74-year-old woman with aortic and mitral valve regurgitation who presented with sudden-onset consciousness disturbance and left complete hemiplegia.
A, Pre-PTA CT scan shows an old infarction in the right basal ganglia without any early CT ischemic changes.
B, Pre-PTA angiogram shows complete occlusion of right MCA trunk (arrow) and right ACA (arrowhead).
C, Angiogram obtained after PTA shows complete recanalization of the MCA trunk.
D, Angiogram obtained after PTA shows embolization in the small cortical arteries (arrows).
E, Follow-up CT scan shows no infarction in the cerebral cortex.
Tables
Clinical and radiologic characteristics in 12 patients
Patient No./Age (y)/Sex Early CT Sign Occlusion Site† Lenticulostriate Artery Involvement Embolic Source‡ Time to PTA (h) Complications§ Initial Symptoms NIHSS Score Cortical Infarct Deep MCA Grade* Superficial MCA Admission After Treatment At 1 Mo 1/67/M II Yes R M1 Present None 3.0 None Hemiplegia 22 12 3 Yes 2/80/M I Yes R M1 Absent PAF 4.0 None Hemiplegia 16 2 None No 3/72/F II No L M1 Present AF 3.5 Small hemorrhage Hemiplegia, aphasia 13 5 1 Yes 4/74/F None No R M1 Present AR, MR 3.5 None Hemiplegia 13 6 2 No 5/71/M II Yes L M1 Present None 2.5 None Hemiplegia, aphasia 21 6 4 Yes 6/49/M None No R M1 Present PAF 7.0 None Hemiparesis 5 0 0 No 7/68/M None No R M1 Present None 5.0 None Hemiplegia 12 4 2 No 8/60/F III Yes L M1 Present PAF 4.0 None Hemiplegia, aphasia 21 13 1 No 9/65/F I Yes L M1 Absent MR 3.0 GI bleeding Hemiplegia, aphasia 12 12 4 Yes 10/70/M II No L M1 Present TR 6.0 None Hemiplegia, aphasia 14 4 1 No 11/69/M III Yes L M1 Present AF 4.5 None Hemiplegia, aphasia 24 8 1 No 12/75/F None No R M1 Present AF 9.0 None Hemiplegia 15 6 1 No * The grades were as follows: I, normal basal ganglia with subtle hypodensity localized to the insula; II, partial obscuration of the posterolateral part of the putamen; and III, hypodensity in the entire lentiform nucleus.
† M1 indicates the M1 portion of the MCA.
‡ AF indicates atrial fibrillation; AR, aortic valve regurgitation; PAF, paroxysmal atrial fibrillation; MR, mitral valve regurgitation; and TR, tricuspid valve regurgitation.
§ GI indicates gastrointestinal.
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