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A Case of the Week

Case 99

 A seventy three-year-old male experienced sudden disorders of speech articulation and motility of left upper and lower extremities. He waited to expect spontaneous recovery for a while in his home. As these symptoms did not get well, his family took him to the local emergency hospital. Medical findings revealed Glasgow coma scale E4N4M6 (Table 1) and arterial fibrillation. Brain CT and MRI were conducted (Figs 1 to 4) which took approximately eight hours after the onset of his episode.

Q1:What are CT findings for early brain infarction ?

1. Loss of gray matter differentiation

2. Hypoattenuation of basal ganglion

3. Cortical hypodensity

4. Gyrus disappearance

5. Insular ribbon sign

6. A hyperdense segment of a vessel


Q2:What is your treatment strategy for this case?

1. Watchful observation

2. Intravenous fibrinolysis

3. Intraarterial thrombolysis

4. Intraarterial retrieval of embolus

5. Surgical thrombo-endolectomy


2018.4.4



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