Cortical calcifications in ischemic stroke

Case contributed by Dr Karina Dorfman

Presentation

Transferred to our institution for rehabilitation, 10 days after left MCA territory stroke, treated by mechanical thrombectomy in another hospital.

Patient Data

Age: 60 years
Gender: Male
CT

Initial CT on admission

Moderately extensive grey and white matter hypodensity with generalized sulcal effacement involving the left lateral parieto-temporal area, head of caudate nucleus, lentiform nucleus and operculum cotices within MCA territory. Mild mass effect. The findings consistent with subacute left MCA infarct.
No acute hemorrhage.

Extensive area with attenuation of CSF in 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.

CT

Follow-up CT , one month after left MCA territory stroke

Follow-up non-contrast CT examination, three weeks after patients' admission for rehabilitation, shows marked well defined gyriform hyperdesity 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 consistent with laminar cortical necrosis.

CT

Follow-up CT , three months after left MCA territory stroke

Follow-up non-contrast CT examination, three months after patients' initial presentation, shows cortical punctuate calcifications within the encephalomalcia 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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Case information

rID: 70023
Published: 5th Apr 2020
Last edited: 5th Apr 2020
Inclusion in quiz mode: Excluded
Institution: Bnai Zion Medical Center

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