If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
A 76-year-old man presented upon waking with dysarthria and left hemiplegia. Head computed tomography (CT) (Figure 1) and CT angiography (Figure 2) showed a large dense focal calcification at the M2 branch point of the right middle cerebral artery, comparable in size to the calcified pineal gland and choroid plexus. Computed tomography perfusion showed a large established infarction.
Comparison of echocardiograms from before and after the stroke showed a highly mobile mitral annular calcification, which was now noticeably smaller in size suggestive of partial embolization.
Calcified emboli have been seen on up to 3% of CT scans ordered for stroke, with small calcific emboli often being asymptomatic. These are important to diagnose because up to half of patients experience a subsequent stroke. Successful endovascular intervention has been reported in acute stroke with no evidence of a large territorial infarction on CT or CT perfusion. However, it may only be possible when the obstruction can be traversed, thus removal of a stone this size is potentially technically difficult. Results with tissue plasminogen activator to this point have been mixed.
Potential Competing Interests: The authors report no competing interests.