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CASE STUDY #3

1/14/2013

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This is a 77 y/o retired woman with worsening problems expressing herself.  She also cannot troubleshoot how to fix her answering machine, drives slower than traffic and is forgetful.  On exam, she cannot recall 3 words after a short delay.  Her speech is halting and sub-fluent making it difficult for her to articulate her thoughts.   She cannot describe major news events.  She substitutes pronouns and vague terms such as 'that tool used to open the cans with' instead of 'can opener'.  The score on the mini-mental is 25/30 when two years earlier it has been 29/30.  An MRI of the brain performed two years earlier revealed signs of small-vessel disease which had been the result of years of untreated high blood pressure but no other abnormalities. 

This PET CT study demonstrates a focal region of decreased blood flow to only the posterior portion of the left hemisphere.  This fits with the vascular distribution for one of the major cerebral arteries.  This woman suffered an embolic stroke at some point since her prior MRI of the brain. 

PET CT
DIAGNOSIS: Left MCA Stroke 
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