Presentation
Transferred to our institution for rehabilitation, 10 days after left MCA territory stroke, treated by mechanical thrombectomy in another hospital.
Patient Data
Moderately extensive grey and white matter hypodensity with generalized sulcal effacement involving the left lateral parieto-temporal area, head of the caudate nucleus, lentiform nucleus, and operculum cortices within MCA territory. Mild mass effect. The findings are consistent with subacute left MCA infarct.
No acute hemorrhage.
Extensive area with attenuation of CSF in the left occipital lobe, in the left PCA territory with ex- vacuo dilatation of the ipsilateral occipital horn of the lateral ventricle. Consistent with old left PCA infarct.
FU CT 1 mth after Lt MCA territory stroke
Follow-up non-contrast CT examination, three weeks after patients' admission for rehabilitation, shows marked well defined gyriform hyperdensity in infarcted cortices of the left lateral parieto-temporal lobes and the insular ribbon, as well as in the head of caudate and lentiform nuclei.
Findings are consistent with laminar cortical necrosis.
FU CT 3 mth after Lt MCA territory stroke
Follow-up non-contrast CT examination, three months after the patient's initial presentation, shows cortical punctuate calcifications within the encephalomalacia area, in the left MCA territory.
Case Discussion
Cortical calcifications after ischemic strokes are rare, with few cases reports in the literature.
In this case, serial CT examinations show a progression from subacute left MCA infarct to laminar necrosis with subsequent formation of cortical calcifications within the area of post-infarction encephalomalacia.
Courtesy of Dr. Nina Borissovsky.
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