Hippocampal and thalamic infarction from vertebral artery dissecting aneursym

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Transfer to INR center with right V1 dissecting aneurysm. Symptoms at onset included right upper and lower limb weakness, sensory loss and incoordination. Right facial paresthesia. Visual field defect and slurred speech.

Patient Data

Age: 75 years
Gender: Male
This study is a stack
Axial
non-contrast
This study is a stack
Coronal
non-contrast
This study is a stack
Sagittal
non-contrast
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Info

Ill defined hypoattenuation of the left hippocampus and posterolateral aspect of the left thalamus. Hyperdense left P2.

This study is a stack
Axial C+
arterial phase
This study is a stack
Coronal C+
arterial phase
This study is a stack
Sagittal C+
arterial phase
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Info

Occlusive filling defect of the left PCA 2

This study is a stack
Axial
FLAIR
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
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Info

Restricted diffusion and low ADC values in the left posterolateral thalamus, cuneus of the left occipital lobe and posterior left parahippocampal gyrus.

Case Discussion

The patient underwent INR sacrifice of the right vertebral artery.

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