Emergency #37

94-year-old female:
– Lower consciousness. E1M3V2
– CT brain: Ischemia? Bleeding? Malignancy?

What do you see?

Complete hypodense right hemisphere with no grey-white matter differentiation possible indicative of ischemia. Large mass effect with subfalcine herniation (midline shift), uncal, and transtentorial herniation. Obliteration basal cisterns Old infarct left frontal and global cortical atrophy

Dx: Malignant medial artery infarction
Coincidental finding: Bilateral course calcifications in basal ganglia and dentate nuclei
Dx: M. Fahr: striato pallido dentate calcinosis

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