Advertisement
Case Report| Volume 22, ISSUE 5, P889-890, May 2015

Calcific emboli originating from the brachiocephalic trunk causing acute cerebral infarction and worm-like calcification in the right middle cerebral artery

Published:January 29, 2015DOI:https://doi.org/10.1016/j.jocn.2014.11.029

      Abstract

      We report, to our knowledge, the first patient with brachiocephalic trunk calcified plaque causing the ‘salted pretzel sign’ and worm-like calcification. Arterial stenosis or occlusion caused by atherosclerosis and thrombosis are responsible for the majority of cases of cerebral infarction. However, there are a number of other causes. Interestingly, these findings were not observed on a CT scan 10 days before the stroke. Acute cerebral infarction with calcifications on unenhanced head CT scans should raise suspicion for disease in the carotid system. Identification of subtle findings of acute ischemic stroke on CT scans is important for early diagnosis and treatment.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Clinical Neuroscience
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kavanagh E.C.
        • Fenton D.M.
        • Heran M.K.
        • et al.
        Calcified cerebral emboli.
        AJNR Am J Neuroradiol. 2006; 27: 1996-1999
        • Christian B.A.
        • Kirzeder D.J.
        • Boyd J.
        • et al.
        Showered calcific emboli to the brain, the ‘salted pretzel’ sign, originating from the ipsilateral internal carotid artery causing acute cerebral infarction.
        Stroke. 2009; 40: e319-e321
        • Moustafa R.R.
        • Antoun N.M.
        • Coulden R.A.
        • et al.
        Stroke attributable to a calcific embolus from the brachiocephalic trunk.
        Stroke. 2006; 37: e6-e8
        • Halloran J.I.
        • Bekavac I.
        Unsuccessful tissue plasminogen activator treatment of acute stroke caused by a calcific embolus.
        J Neuroimaging. 2004; 14: 385-387