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Images in Neurology |

Neuroimaging of Transient Ischemic Attack

Alfonso Cerase, MD; Ignazio Maria Vallone, MD; Rossana Tassi, MD; Matteo Bellini, MD; Giuseppe Martini, MD; Carlo Venturi, MD
Arch Neurol. 2010;67(6):772-773. doi:10.1001/archneurol.2010.96.
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A hospitalized 81-year-old man with hypertension, chronic obstructive pulmonary disease, lower-limb obstructive arteriopathy, and antithrombin III deficiency who was being treated with low-molecular-weight heparin, clopidogrel bisulfate, and acetylsalicylic acid presented with sudden aphasia and right hemiplegia. Brain computed tomography (CT) results were negative; CT angiography (CTA) of the cervicocranial arteries (Figure, A) showed an occluded left middle cerebral artery M1 segment. One hour later, the symptoms completely regressed. Shortly afterward, results from brain diffusion-weighted imaging (Figure, B) and apparent diffusion coefficient maps were negative. Magnetic resonance (MR) angiography of the intracranial arteries (Figure, C) showed complete recanalization of the left middle cerebral artery. Six weeks later, results on MR imaging of the brain and MR angiography of the intracranial arteries were unchanged.

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Computed tomographic angiography, diffusion-weighted imaging, and magnetic resonance angiography results. A, At 11:59 AM, computed tomographic angiography showed a completely occluded left M1 segment (arrows). B, At 1:26 PM, diffusion-weighted imaging results were normal. C, At 1:33 PM, magnetic resonance angiography showed complete recanalization of the left middle cerebral artery (arrows).

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