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Case Reports
. 2023 Aug 17;15(8):e43665.
doi: 10.7759/cureus.43665. eCollection 2023 Aug.

Infarcts of a Cardioembolic Source Mimicking Lacunar Infarcts: Case Series With Clinical and Radiological Correlation

Ahmed Harazeen  1 , Muhammad Z Memon  1 , Heitor Frade  1 , Arun Chhabra  1 , Umar Chaudhry  2 , Hashem Shaltoni  1
Affiliations
Case Reports

Infarcts of a Cardioembolic Source Mimicking Lacunar Infarcts: Case Series With Clinical and Radiological Correlation

Ahmed Harazeen et al. Cureus. .

Abstract

Lacunar strokes are the hallmark of cerebral small vessel disease. There are several well-established mechanisms for the pathogenesis of lacunar stroke, but the cardioembolic mechanism is not well-established. Three cases of acute ischemic stroke following elective cardiac and cerebral catheterization are reported. These cases had typical lacunar-looking infarcts on neuroimaging despite strong evidence of an embolic source with temporal correlation. Awareness of such findings and pathogenesis may help investigational workup and management of these patients.

Keywords: clinical correlation; embolic source; heart catheterization complications; lacunar infarcts; radiological correlation.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Axial MRI images
(A,B) DWI and ADC showing an acute small right posterior pontine infarct (white arrows) (C,D) DWI sequence and ADC showing an acute small infarct in the right cerebellar region (dashed arrows) DWI, diffusion-weighted image; ADC, apparent diffusion coefficient
Figure 2
Figure 2. Axial MRI images
(A,B) DWI and ADC showing an acute left pontine infarct (white arrow) (C) FLAIR sequence showing bilateral chronic infarcts in the right middle cerebral artery territory (right frontal operculum and right temporal lobe with a peripheral watershed infarct in the left parietal-occipital junction) (two dashed arrows) DWI, diffusion-weighted image; ADC, apparent diffusion coefficient
Figure 3
Figure 3. Axial MRI images
(A,B) DWI and corresponding ADC showing an acute right hemi-pons lesion (solid arrow) (C) FLAIR sequence showing multiple T2/FLAIR hyperintensities in a supratentorial deep, subcortical, and periventricular white matter consistent with chronic microvascular ischemic changes (dashed arrows) DWI, diffusion-weighted image; ADC, apparent diffusion coefficient
See this image and copyright information in PMC

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References

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