case_images: PMC5632496_01
case_images: Axial unenhanced head CT scan (a) on the stroke windows (40/40 HU) demonstrated a low attenuation area in the right insular cortex (arrow). On CT angiography with coronal Minimal Intensity Projection (b) and reconstructed 3D (c) images, complete circle of Willis was identified with no gross findings of occlusion. The mean transit time (MTT) (d) showed no significant asymmetry. The cerebral blood volume (CBV) map (e) and the cerebral blood flow (CBF) map (f) demonstrated a slight asymmetry with increased CBV and CBF, respectively, in the posterior right frontal region just above the subinsular cortex extending along the anterior aspect of the subinsular cortex (arrow). The time to drain (TTD) map (g) revealed asymmetrically delayed blood drainage from the left posterior frontal region including the entire subinsular cortex (arrow). Luxury perfusion following cerebral infarction is the most likely diagnosis in the presence of changes on the unenhanced portion of the CT examination.
case_images: CRIPE2017-6576382.001.jpg
case_images: PMC5632496_01_CRIPE2017-6576382.001.jpg
case_images: fig1
case_images: CT demonstrated an area of hypoattenuation in the right frontal lobe with hyperemia at the same site with contrast study, suggestive of enhanced reperfusion after ischemic stroke (Figure 1). CT angiography did not show any obstruction of cerebral arteries.
case_images: Images of hypertrophic cardiomyopathy (HCM) and a thrombus in the left ventricular (LV) apex. (a) Parasternal long axis view (a) showed severe concentric hypertrophy of interventricular septum (IVS) and LV free wall, but without an echogenic mass in the apex. (b) Off-axis apical four-chamber view identified a round echogenic mass in the LV apex measuring 1.3 x 1.4 cm (arrow). (c) A coronal reformat of postcontrast chest CT demonstrated cardiomegaly with an intracardiac thrombus at the LV apex measuring up to 1.8 cm (arrow). Ao: aorta, LA: left atrium, and LV: left ventricle.
case_images: CRIPE2017-6576382.002.jpg
case_images: PMC5632496_01_CRIPE2017-6576382.002.jpg
case_images: fig2
case_images: CT scan (Figure 2). Coagulation profile was normal.