Presentation
5 days postpartum women presented with acute onset of aphasia and a right-sided paresis.
Patient Data
Relatively loss of grey-white matter differentiation and subtle low attenuation in the left frontal lobe.
Annotated images of the non-contrast CT with the corresponding DWI show the subtle areas of infarction in the CT scan with the corresponding area in the DWI.
MRI shows restricted diffusion in the distribution of the distal segment of left MCA in keeping with an acute infarct. Note the subtle signal in the flair and T2 sequences.
Case Discussion
Small infarcts may be hard to appreciate on CT for days, narrower window width with higher contrast setting (stroke settings) is more sensitive in detecting subtle grey/white matter changes than standard brain settings, MRI with the DWI is sensitive in the detection of small and early infarcts.