MCA calcified embolism

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

End-stage renal failure. Confusion and mild headache.

Patient Data

Age: 60 years
Gender: Female
ct

Patchy hypodensity in the white matter of the middle cerebral artery territory is noted. There is also positive mass effect in the region with loss of grey-white matter differentiation and probable cortical swelling.

In the Sylvian fissure, a branching calcific density is present consistent with a calcified embolus, with the largest component extending into the inferior division of the MCA. Features are those of a subacute infarct secondary to a calcified thromboembolism. 

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