MedPix® Patient Chart - Case No: 4515 :: Imaging - Review Images

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History

Age: 20 :: Gender: Woman

Patient History

2 day history of occipital headache and visual field defect

Exam


Physical Exam and Laboratory

Quadrantanopsia (right upper outer visual field defect).

Serum anticardiolipin positive for "lupus-like" anticardiolipin antibodies.

Echocardiogram - a patent foramen ovale (PFO) diagnosed echocardiographically with a bubble study.


Imaging

Imaging - Review Images for PT: 4515

Findings


Summary of Findings

Plain CT: area of decreased attenuation left medial occipital lobe involving cortex and subcortical white matter

MRI w/ DWI: area of "light bulb bright signal" left medial occipital lobe - intracellular cytotoxic edema

MRA: normal (not shown)


Imaging

Imaging - Review Images for PT: 4515

Diffferential


Differential Diagnosis

calcarine cortex infarction due to:

  • emboli

    • cardiac
    • noncardiac
    • paradoxical

  • atherosclerosis
  • dissection
  • vasculitis
  • vasospasm
  • moyamoya disease
  • hypercoagulable states
  • hemoglobinopathies


    • Imaging

    Imaging - Review Images for PT: 4515

    Diagnosis


    Diagnosis

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    Treatment


    Treatment and Followup

    Treatment not available without Diagnosis

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    Discussion

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    Topic

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    Case Contributor and Editor
    Topic Author: Linda P Thomas
    		Submitted by: Linda P Thomas - Author Info
    Case/Image Editor: James George Smirniotopoulos, M.D. - Editor Info
    Case Accepted: :: Revised: :: Submitted:
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