Concluded Case

Acute Left PCA Infarction.

New Case. 44 yr old F ,No kown comorbidities, presented with rt sided weakness developed on 5th of this month at 19:30 hrs and presented on 6th at 10: 30 hrs. Denied having any joint / skin problem. Not on any hormonal med. No family history of young stroke. On exam BP 120/70 mmhg. No neurocutaneous markers noted Rt homonymous hemianopia with gr 3/ 5 power Rt side with Rt pyramidal signs Intact sensations. No bruit overthe carotids/ vertebrals.Cardiace evaluation normal. Routein blood workup normal. Vasculitis screening normal. Started medical management as per stroke protocol Diagnosis and structure affected?

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Concluded answer
Thanks to all answers. Discussion : Diagnosis and structures involved. Diagnosis: Acute ischemic infarction in LEFT PCA. Structures involved: Large area of T2 / FLAIR hyperintense signals in Lt Occipitotemporal and posterior parietal cortical and subcortical regions,left peritrigonal region and left thalamus. Multiple punctuate hyperintense foci noted in deep and subcortical white matter of bilateral frontal & parietal region Suggestive of small vessel ischemic lesions
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LT SIDE ISCHAEMIA SEEN AFFECTING CEREBELLAR TONSILS, CEREBELLAR PEDUNCLES, HIPPOCAMPUS,VERMIS. TENTORIUM CEREBELLI,
Thanks to all answers. Discussion : Diagnosis and structures involved. Diagnosis: Acute ischemic infarction in LEFT PCA. Structures involved: Large area of T2 / FLAIR hyperintense signals in Lt Occipitotemporal and posterior parietal cortical and subcortical regions,left peritrigonal region and left thalamus. Multiple punctuate hyperintense foci noted in deep and subcortical white matter of bilateral frontal & parietal region Suggestive of small vessel ischemic lesions
Left Cerebellar infarct with Haemorrhagic transformation due to occlusion in post circulation.Watch for Hydrocephalus Rx - Systemic Antibiotics,Antiplatelets,statin and AEDs,Cerebral decongestant if there is any sign of raised ICP present,IV fluids along with supportive treatment.
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Lt sided Cerebeller Ischaemia n Occipital area seen
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Can I see the patient visually
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