Case 92

 A seventy four-year-old male found difficulty of elevating left arm during squatting a week ago. It was recovered 10 minutes later. When he stepped down from his car two days ago, he experienced to be hard to move left upper arm,again. After he received gastrectomy, he had anemia and diabetes mellitus. Blood pressure 118/74 mmHg. When he presented in our hospital, he was diagnosed TIA (transient ischemic attack) and TIA score of ABCD2 was 5 (age, more than 60 years, 1; blood pressure 140mmHg or greater, 90 mmHg or greater, 0; clinical features, hemi-lateral paresis, 2; duration time less than 60 minutes, 1: diabetes mellitus, 1). He agreed to receive brain CT and MRI for further investigation.

Based on clinical findings and brain CT and MRI (Fig. 1-5), what is your diagnosis?

1. Transient ischemic attack

2. Atherosclerotic brain infarction

3. Hypertensive brain hemorrhage

4. Cerebral amyloid angiopathy

5. Brain embolism

answer

2018.2.14