PMC10071904_01
(a) Dry gangrene of the distal part of the right ring finger. (b) Plain CT brain showing multiple hypodensities in bilateral cerebellar lobes suggestive of ischemic stroke. (c) Plain CT brain showing bilateral occipital hypodensities, left more than right, suggestive of posterior circulation ischemic stroke. (d) MRI of the brain:FLAIR sequence which shows hyperintensity in the posterior cerebellum:PICA territory. (e) MRI of the brain:flair sequence showing hyperintensities in bilateral thalami and occipital region. (f) MR angiogram of the circle of Willis showing narrowing of P1 and P2 segments of posterior cerebral artery on the left side
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Local examination revealed swelling and severe tenderness over the right ring finger with blackish discoloration of the distal part of the right ring finger [Figure 1a]. Tomography (NCCT) brain revealed a hypodense lesion in the bilateral basal ganglia, and bilateral occipital lobe (left more than right) consistent with ischemic stroke [Figure 1b and c]. MRI brain with MRA showed multiple infarcts, the largest in the cerebellum and occipital areas with a filling defect in the left vertebral artery [Figure 1d, 1e and 1f].