case_images: PMC10826401_01
case_images: (a) Head CT with intraparenchymal and intraventricular hematoma of the right parietal and occipital lobes, associated with edema, and mass effect. (b) Brain MRI: Post-contrast T1: Normal vascular structures were observed within the circle of Willis. No significant stenosis, arteriovenous malformations, nor aneurysms larger than 3 mm were observed. Uptake in the blood vessel walls of the circle of Willis was observed (Yellow arrows and dotted lines). (c) Angiography: No aneurysms, arteriovenous malformations, nor dural fistulas were observed. No significant stenosis was observed. A slow capillary phase, with delay in the venous phase in both cerebral hemispheres was observed.
case_images: 10.1177_2050313X241228410-fig1.jpg
case_images: PMC10826401_01_10.1177_2050313X241228410-fig1.jpg
case_images: fig1-2050313X241228410
case_images: The hemorrhage extended to the right parietal and occipital lobe, with surrounding edema, 7 mm midline shift, and intraventricular hemorrhage (Figure 1). Pan-angiography showed no aneurysms, AVMs, or dural fistula (Figure 1).
case_images: Mitral valve with a mobile, ecodense image attached to the ventricular surface of the anterior veil, compatible with vegetation, veil perforation, and severe insufficiency.
case_images: 10.1177_2050313X241228410-fig2.jpg
case_images: PMC10826401_01_10.1177_2050313X241228410-fig2.jpg
case_images: fig2-2050313X241228410
case_images: Therefore, transthoracic echocardiography was performed, showing 23 mm mitral valve vegetation in the anterior leaflet, associated with perforation and severe insufficiency (Figure 2).