Presentation
Sudden onset right facial droop and left arm weakness. Has not resolved over 2 hours.
Patient Data
Age: 65 years
Gender: Male
From the case:
Stroke - subtle
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Subtle loss of grey-white matter differentiation at the right insula and frontal operculum. The deep grey matter structures and remainder of brain parenchyma are normal. There is no convincing dense MCA sign.
Case Discussion
A good example of the usefulness of review areas. In this particular case, the clinical information is quite convincing for stroke but on initial review there is no obvious dense infarct. Review areas include grey-white matter differentiation at the insular cortex and deep grey matter structures, along with evaluation for a dense vessel. Venous sinuses should also be evaluated.
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