Article Figures & Data
Figures
- Figure 1
Non-contrast CT scan brain showing A) and C) no CT signs of acute infarction or hemorrhage. B) Axial image and D) Coronal image showing focal hyper-density at the M2 segment of the left middle cerebral artery (MCA dot sign).
- Figure 2
Magnetic resonance imaging with diffusion-weighted image (DWI), apparent diffusion coefficient (ADC) and axial fluid attenuated inversion recovery (FLAIR) WI showing: A) Acute infarction of the left lentiform nucleus and corona radiata region with high signal on DWI (arrow in A); B) Low signal on ADC (arrow in B); C) FLAIR WI with loss of the normal signal void along the M2 and M3 branches of the left middle cerebral artery (arrow in C) implying slow blood flow.
- Figure 3
3-D time-of-flight magnetic resonance angiogram (3 hours after stroke onset) showed A) left middle cerebral (MCA) segment with contrast enhancement, B), C), & D) signal attenuation from the M2 segment of the left MCA depicted with arrows graded as partial thrombo-embolic occlusion.
- Figure 4
Maximum intensity projection 3-D time-of-flight magnetic resonance angiogram of the circle of Willis (3 hours and 30 minutes after stroke onset) showing: A and B) thrombo-embolic filling defect at the M2 segment (short white arrows in A and B), narrowing distal M2 segment (short grey arrows in A and B) and pruning of M3 segment branches (long white arrow in A and B) of the left middle cerebral artery.
- Figure 5
Non-contrast CT scan brain (26 hours after stroke [22 hours after IV thrombolysis]) showed: A) previously seen hyperdense left middle cerebral artery dot sign in the M2 segment is less prominent. B), C) and D) showed acute linear infarction at the left lentiform and head of caudate nuclei.
- Figure 6
Follow up coronal A) and axial B) maximum intensity projection 3-D time-of-flight magnetic resonance angiogram, axial fluid attenuated inversion recovery [FLAIR] C) and coronal D) T2 WI MRI showing: A) Patent M2 segment of left middle cerebral artery. B) Good filling of M3 segment branches. C) Chronic infarction at left lentiform nucleus. D) Chronic infarction at head of caudate nucleus.
Tables
- Table 1
Complete laboratory test data (some test results were rechecked on follow-up as shown by values with / sign).
Laboratory test Reference Patient value Hemoglobin (g/dl) 12 - 16 12 White blood count (Ku/L) 4 - 11 3.2 Platelets (Ku/L) 150 - 400 180 MCV (fl) 76 - 96 81.6 MCH (pg) 27 - 32 25.3 ESR (mm/hr) 0 - 20 44 BUN (mmol/L) 2.5 - 6.7 4.3 Creatinine (umol/L) 50 - 98 59 Blood sugar (mmol/L) 2.9 - 7.8 5.6 LDL (mmol/L) < 2.6 2.25 PT (second/s) 11 - 14.5 12.4 PTT (seconds/s) 26.1 - 37.3 36.1 INR 0.8 - 1.2 1 TSH 0.35 - 4.94 8.09 / 5.27 Free T4 (pmol/L) 9 - 19 10.34 / 11.56 25-OH Vit D (nmol/L) 75 - 250 78.4 CRP (mg/L) < 5 6.7 / 4.1 Fibrin degradation product (mg/L) 0 - 0.5 2.9 Fibrinogen (gm/L) 1.5 - 4.1 1.6 Anti-CCP IgG antibody (unit) < 20 0.84 Sickle cell screening Negative ANA index < 1.2 > 12 AntiDNA (IU/ml) < 20 52.8 Vitamin B12 (pmol/L) 132 - 857 175 Homocysteine (umol/L) < 15 7.9 Antithrombin III (%) 75 - 125 106 Functional protein C (%) 70 - 130 104 Protein S activity (%) 65 - 140 69.8 APC resistance (%) 0.9 - 1.3 0.9 Factor 5 assay (unit/ml) 0.5 - 1.5 0.74 Lupus anticoagulant ratio 0 - 1.2 2.1 / 2.5 LA 1 (secs) 30 - 43 85.1 / 131 LA 2 (secs) 26.5 - 32.5 39.6 / 52.6 Beta-2 glycoprotein IgG (U/ml) < 10 35.68 IgM (U/ml) < 12 3.59 IgA (U/ml) < 3 6.43 Anticardiolipin antibody IgG (GPL Unit/ml) < 10 37.76 / 34.06 IgM (MPL Unit/ml) < 7 6.02 / 6.30 IgA (APL Unit/ml) < 10 6.23 / 8.57 CANCA (U/ml) < 10 1.48 PANCA (U/ml) < 6 4.78 C3 (g/L) 0.83 - 1.93 1.05 C4 (g/L) 0.150 - 0.570 0.362 Anti SM (U/ml) < 5 5.04 Anti SS-A (U/ml) < 4 8.26 Anti SS-B (U/ml) < 4 1.28 24 hr urine protein (gm/day) - (g/L) 0.05 - 0.14 < 0.07 24 hr urine creatinine (mmol/day) 06.3 - 14.6 8.0
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