case_images: PMC10864161_01
case_images: Images of a 54-year-old male with a thrombus within an interventricular membranous septal aneurysm leading to cerebral infarction.. A. Brain MR image (diffusion weighted image) shows an acute cerebral infarction in the left frontal lobe.. B. Brain MR angiography shows no significant stenosis or other abnormality.. C. Transthoracic echocardiography shows an aneurysm in the membranous portion of the interventricular septum, protruding into the right ventricle (arrow).. D. Cardiac CT shows an interventricular membranous septal aneurysm (arrow).. E. CT image reconstructed in a 4-chamber view shows a low attenuating thrombus within the aneurysm (arrow), with a CT number of the thrombus of approximately 50 Hounsfield units.. F. Follow up imaging of the aneurysm within the interventricular membranous septal aneurysm is shown. A low attenuating thrombus within the interventricular membranous septal aneurysm is shown on initial CT image (left, arrow). The thrombus within the aneurysm nearly disappeared on follow-up CT image about one month after starting of warfarin (right).
case_images: jksr-85-210-g001.jpg
case_images: PMC10864161_01_jksr-85-210-g001.jpg
case_images: F1
case_images: Brain MRI and angiography revealed a cerebral infarction in the left frontal lobe (Fig. 1A) and no significant stenosis or other abnormalities (MR angiography; MRA) (Fig. 1B). Transthoracic echocardiography revealed no lesions that could be a source of the embolism, such as an intracardiac shunt or patent foramen ovale; however, an aneurysm was detected in the membranous portion of the interventricular septum (Fig. 1C). This examination revealed an outpouching lesion in the membranous portion of the interventricular septum protruding towards the right ventricle, suggesting an interventricular membranous septal aneurysm (Fig. 1D). A low-attenuation lesion within the aneurysm was detected on the reconstructed image (Fig. 1E). The thrombus within the interventricular membranous septal aneurysm had nearly disappeared on follow-up CT approximately one month after starting warfarin (Fig. 1F).