Transcript Slide 1 - AccessPharmacy

Acute stroke confirmed by diffusion-weighted magnetic resonance image (MRI). A 39 year-old man presented with left facial weakness that began 3 hours
earlier after smoking crack cocaine. He also complained of left arm “tingling” but had normal examination findings. An emergency noncontrast computed
tomography (CT) scan was obtained that was interpreted as normal (A), although in retrospect there was subtle loss of the normal gray–white
differentiation (arrow). MRI was obtained to confirm that the facial palsy was a stroke and not a peripheral seventh cranial nerve palsy. Standard MRI
sequence (T1-weighted, T2-weighted, and FLAIR) were normal in this early ischemic lesion (B and C). Diffusion-weighed imaging is able to show such
early ischemic change—cytotoxic (intracellular) edema (D). The patient’s facial paresis improved but did not entirely resolve. A repeat CT scan 2 days
Source: Diagnostic Imaging, Goldfrank's Toxicologic Emergencies, 10e
later showed an evolving (subacute) infarction with vasogenic edema (E). Infarction was presumably caused by vasospasm because no carotid artery
Citation:
Hoffman
RS, Howland
M, Lewin
NA, Nelson
LS,DT:
Goldfrank
LR. Goldfrank's
Emergencies,
2015 Available
at:
lesion or cardiac
source
of embolism
was found.
(From
Schwartz
Emergency
Radiology:Toxicologic
Case Studies,
New York,10e;
McGraw-Hill;
2008:517,
with
http://mhmedical.com/
Accessed:
April
06,
2017
permission.)
Copyright © 2017 McGraw-Hill Education. All rights reserved