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Quiz case: a clinical reasoning challenge in the emergency stroke setting

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Abstract

A right-handed woman in her 80s was admitted to the emergency department 1 h after sudden-onset global aphasia and right-sided hemiparesis. Medical history included arterial hypertension, dyslipidemia, hyperuricemia, aortic stenosis, osteoporosis, and recent pulmonary embolism. Medication consisted of apixaban, bisoprolol, hydrochlorothiazide, allopurinol, fenofibrate, and vitamin D. Vital parameters (blood pressure, heart rate, body temperature, oxygen saturation) and glycemia were all within normal range. Electrocardiogram showed a first-degree atrioventricular block. The patient was promptly transported to the emergency computed tomography (CT) scanner. Non-contrast brain CT revealed a unilateral hyperdensity in the left caudate and lentiform nuclei. No other intracranial lesion was visualized. Laboratory studies were not yet available at the time of imaging. What is your diagnosis?

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SD has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

References

  1. Morales H (2018) Pitfalls in the imaging interpretation of intracranial hemorrhage. Semin Ultrasound CT MRI 39(5):457–468. https://doi.org/10.1053/j.sult.2018.07.001

    Article  Google Scholar 

  2. Dehkharghani S, Dillon WP, Bryant SO, Fischbein NJ (2010) Unilateral calcification of the caudate and putamen: association with underlying developmental venous anomaly. Am J Neuroradiol 31(10):1848–1852. https://doi.org/10.3174/ajnr.A2199

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Aoki R, Srivatanakul K (2016) Developmental venous anomaly: benign or not benign. Neurol Med Chir 56(9):534–543. https://doi.org/10.2176/nmc.ra.2016-0030

    Article  Google Scholar 

  4. Semenov S, Moldavskaya I, Shatokhina M, Semenov A, Barbarash L (2011) How to distinguish between arterial and venous strokes and why? Neuroradiol J 24:289–299. https://doi.org/10.1177/197140091102400219

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium

    Sofia Maldonado Slootjes & Sylvie De Raedt

  2. Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium

    Koenraad Nieboer

Authors
  1. Sofia Maldonado Slootjes
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  2. Koenraad Nieboer
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  3. Sylvie De Raedt
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Contributions

All authors contributed to the patient’s care. The first draft of the manuscript was written by SMS, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sofia Maldonado Slootjes.

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Written consent for publication was obtained from the patient’s next of kin. The manuscript was written in accordance to the institutional ethical standards.

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The authors declare no competing interests.

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Maldonado Slootjes, S., Nieboer, K. & De Raedt, S. Quiz case: a clinical reasoning challenge in the emergency stroke setting. Neurol Sci 44, 4159–4161 (2023). https://doi.org/10.1007/s10072-023-06996-2

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  • DOI: https://doi.org/10.1007/s10072-023-06996-2

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