Concluded Case

Young Stroke due to cerebral vasculitis

New Case 41ye,F ,Presented with Rt hemicranial head ache 2 days and mild left sided weakness of 1 day duration.Head ache dull aching type almost continuous with out any vomiting or visual symptoms.The next day she developed acute onset of mild left sided weakness which she noted while getting up from sitting position. She is a known case of Sjogrens syndrome, renal impairement,DM with autoimmune thyroiditis and on multiple med including immunosuppressive. On exam Bp140/ 80 mmhg ,intact memory and speech normal optic fundi,left sided mold facial palsy with gr 4/5 power left side.DTRS equal both sides with unresponsive left plantar. Diagnosis with structures involved and possible cause.

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Thanks Curofy and others. Discussions:Diagnosis,structures involved ,possible cause. Acute and subacute infarction along with surrounding edema Rt side. MRI - T1 / FLAIR hyperintense,T1 subtle hypointense signals seen diffusely in the Rt basal ganglia,head of caudate nucleus,external capsule extends superiority up to the corona radiata,inferiority up to the frontal lobe.Mild mass effect on adjacent frontal horn & sylvian fissure.MRA reveals diffuse luminal narrowing of bilateral MCA,mild narrowing of distal M1 segment. Features suggestive of vasculitis
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Look acute CVA due to Cns vasculitis K/C/O sjogrens syndrome with autoimmune Thyroiditis and DM On immunosupression medicine MRI brain-Rt. Caudate nucleus- putaminal hemorrhagic infarct Need to see DWI and details of previous report MRI ANGIO- FILLING DEFECTS IN B/L MCA POSSIBILITY OF CAUSE SLE CNS Vasculitis NEEDS MEDICAL CONSERVATIVE TREATMENT Titre the dose of oral immunosuppression
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CvA thromboembolic infarct Rt MCA territory
Thanks Curofy and others. Discussions:Diagnosis,structures involved ,possible cause. Acute and subacute infarction along with surrounding edema Rt side. MRI - T1 / FLAIR hyperintense,T1 subtle hypointense signals seen diffusely in the Rt basal ganglia,head of caudate nucleus,external capsule extends superiority up to the corona radiata,inferiority up to the frontal lobe.Mild mass effect on adjacent frontal horn & sylvian fissure.MRA reveals diffuse luminal narrowing of bilateral MCA,mild narrowing of distal M1 segment. Features suggestive of vasculitis
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right cerebral stroke involved fronto parietal lobe drug induced ,mild hypertension,renal impairment,dm with autoimmune thyroditis
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