case_images: PMC10870102_01
case_images: Imaging findings of calcified cerebral emboli in this case. a: Diffusion-weighted imaging reveals a high-intensity lesion in the right middle cerebral artery (MCA) territory (arrowhead).. b: T2*-weighted gradient echo imaging shows no sign of susceptibility vessel in the right Sylvian fissure.. c: Magnetic resonance angiography (MRA) on admission shows no major branch occlusion in the right MCA.. d: Axial computed tomography (CT) images reveal a high-density spot suspected to be a calcified embolus in the right Sylvian fissure (arrow).. e: Follow-up MRA shows recanalization of the right M2 segment (arrowheads).. f: Follow-up CT performed 24 hours after intravenous thrombolysis revealed low-density lesions at the middle MCA territory (arrowheads) and migration of the calcified embolus to the distal MCA (arrow).. g: CT angiography shows calcified plaque at the cervical segment of the right internal carotid artery (ICA) (arrowheads).. h: Carotid ultrasonography shows calcified plaque at the cervical segment of the right ICA (arrowheads).
case_images: cureus-0016-00000052593-i01.jpg
case_images: PMC10870102_01_cureus-0016-00000052593-i01.jpg
case_images: FIG1
case_images: Brain magnetic resonance imaging (MRI) showed acute cerebral infarction in the right insular cortex in diffusion-weighted imaging (Fig. 1a). T2*-weighted gradient echo imaging showed no susceptibility vessel sign (SVS) in the right Sylvian fissure (Fig. 1b). Moreover, there seemed no occluded branches of the right MCA in the MR angiography (MRA) (Fig. 1c). Brain NCCT revealed calcification in the right Sylvian fissure, which was considered as vessel wall calcification (Fig. 1d). However, a follow-up MRA on day two revealed recanalization of the right M2 branches (Fig. 1e). NCCT performed revealed low-density lesions in the middle MCA territory and migration of the calcification to the distal MCA (Fig. 1f). Carotid ultrasonography (LOGIQ E8, GE Healthcare, Chicago, IL) and cervical CT angiography revealed stenosis at the cervical segment of the right ICA with ulceration (Fig. 1g, Fig. 1h).