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Case Reports
. 2018 Feb 20;90(8):386-391.
doi: 10.1212/WNL.0000000000004995.

Clinical Reasoning: An unusual cause of adult cryptogenic ischemic stroke

Mark L Leekoff  1 , Julia E Masur  1 , Allen P Burke  1 , Jeremy S Pollock  1 , Matthew N Peters  1 , Si M Pham  1 , Timothy R Miller  1 , John W Cole  2
Affiliations
Case Reports

Clinical Reasoning: An unusual cause of adult cryptogenic ischemic stroke

Mark L Leekoff et al. Neurology. .
No abstract available

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Figures

Figure 1
Figure 1. Time-of-flight (TOF) magnetic resonance angiography (MRA) and susceptibility-weighted imaging (SWI) MRI
(A) TOF MRA demonstrates occlusion of the right middle cerebral artery (MCA). (B) SWI MRI demonstrates absent “blooming” as might be expected from a clot in right MCA.
Figure 2
Figure 2. Transesophageal echocardiography (TEE)
(A) Re-review of transthoracic echocardiogram depicts potential echodensity (arrow) attaching to the aortic valve commissures between the right and left coronary cusps in short axis. (B) TEE depicts 1 × 1 cm papillary fibroelastoma attaching to the aortic valve commissures between the right and left coronary cusps in long axis. (C) TEE depicts 1 × 1 cm papillary fibroelastoma attaching to the aortic valve commissures between the right and left coronary cusps valve in short axis. (D) 3D echocardiography depicts 1 × 1 cm papillary fibroelastoma attaching to the aortic valve commissures between the right and left coronary cusps in short axis.
Figure 3
Figure 3. Surgically resected fibroelastoma specimen, 1.0 × 1.0 × 1.0 cm
Figure 4
Figure 4. The tumor and the papillary structures
(A) The tumor at low magnification is composed of multiple branching papillae. (B) At high magnification, the papillary structures are avascular and are filled with amorphous myxoid ground substance. There is a single surface lining of endothelial cells.
See this image and copyright information in PMC

References

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