Case 246

 We present two cases with multiple brain infarctions. CT images of both cases are very similar, multiple small high signal intensity in right and left brain lobes on diffusion weighted imaging (DWI).

 Case A: An eighty six-year-old female. She suffered from bacteremia from unknown origin, fever and loss of consciousness. Laboratory test revealed CRP 16.57 mg/dl, white blood cells 17.13 X 10 mm3, neutrophils 94.7%, procarcitonin 2.22 ng/mL. She took brain MRI for further examination (Fig.1)
 Case B: A seventy one-year-old male. He suffered from advanced intrahepatic cholangiocarcinoma. Laboratory test revealed CRP 9.58 mg/dl, procarcitonin 0.23 ng/mL, white blood cells 3660/mm3, platelets 205000/mm3.

What can cause bilateral multiple brain infarctions?

A.　Bacterial endocarditis B.　Non-bacterial thrombo-endocarditis C.　Trousseau syndrome D.　Cholesterol embolism E.　Atrial fibrillation

1.　A,B,C

2.　B,C,D

3.　C,D,E

4.　A,D,E

5.　all

answer

2021.10.11