Multiple Lunar Infa...
 
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[Sticky] Multiple Lunar Infarcts

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(@nlzturtle)
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47 year old female. Started having neurologic issues in 2019. In emergency room in Tampa General now. Test impression interval development of likely late subacute to chronic small lacuna infarcts within the right corona radiata as well as a few punctate cortical and subcortical infarcts in the right frontal and parietal lobes. No evidence of acute infarct.

There has also been interval development of multiple lacunar infarcts within the right caudate nucleus, corona radiata, basal ganglia and external capsule which are more chronic in appearance but new since 3/30/2023

New small focus of cortical enhancement in the right frontal lobe, likely related to breakdown of the blood-brain barrier from small subacute to chronic infarct. No other abnormal enhancement.

Stable appearance of small remote lacunar infarcts within the cerebellum bilaterally.

She was in the ER last Saturday with left arm weakness and drooping left side of face. She was sent home

She again in the ER 2 days ago. Left arm completely numb.

She has been having numerous thoughts of dying.

 

All tests run so far, MRI, Cat scans Head and Neck and Stomach, ECObubble test. All have been clear with nothing to indicate what is happening. She is scheduled for a lumbar puncture and angiogram.

 

Looking for any information on where we should go from here. What is being missed?

 

 

2 Replies
Carol Petersen
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(@carol-petersen)
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Joined: 10 months ago

@paulwandmd  would your workup be appropriate for this?

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(@max441)
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Joined: 2 months ago

hi 

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