Multiple cerebral acute infarcts (cardiogenic emboli)
Severe atrial fibrillation with atrial thrombus on echocardiogram.
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Multiple small cortical/subcortical infarcts scattered along all the left cerebral hemisphere (left MCA and PCA territories) and also in the right frontal lobe (right MCA). Severe white matter changes consistent with chronic small vessel ischemia.
Given the multiplicity of small infarcts involving at least three different vascular territories in both cerebral hemisphere and the known history of a cardiac source of emboli, this case can be interpreted as a cardiogenic emboli shower causing multiple brain infarcts.