PMC7880116_01
(A) non-contrast CT Head demonstrates left middle cerebral artery territory infarct with pressure effect effacing cortical sulci and ipsilateral lateral ventricle anterior horn; (B) AP chest X-ray revealed features of right lung pneumonia seen as patchy peripheral faint ground glass shadowing in the right lower zone
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A). A chest x-ray done on admission revealed patchy peripheral faint ground glass shadowing (Figure 1 B).
PMC7880116_02
(A) GRE Haem sequence demonstrates low signal intensity in the region of right basal ganglia representing haemorrhagic transformation; (B) MRI DWI shows multiple hyperintense areas of restricted diffusion in the cerebellum in keeping with acute infarctions; (C): chest X-ray, AP reveals poorly defined infiltrates in the right upper zones suggestive of pneumonic changes
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Patient s brain magnetic resonance imaging (MRI) showed right temporal-parietal ischemic stroke with hemorrhagic transformation (Figure 2 A) as well as cerebellar infarcts (Figure 2 B). An x-ray of the chest revealed poorly defined infiltrates in the right upper zone suggestive of pneumonic changes (Figure 2 C).
PMC7880116_03
(A) MRI DWI revealed hyperintense signal in the right MCA territory which involved right fronto parietal temporal lobes as well as capsuloganglionic region, indicating abnormal fluid restriction in those areas; (B) 3D TOF MRA revealed extended right internal carotid (intracranial portion) stenosis with near-total occlusion of the right middle cerebral artery; (C) portable chest X-ray shows cardiomegaly and features of interstitial edema seen as bilateral parahilar and lower zone infiltrates
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A) and extensive right internal carotid artery stenosis (Figure 3 B) Laboratory work up (Table 1) was significant for neutrophylic leucocytosis, increased ferritin and lactate dehydrogenase. An x-ray of the chest (Figure 3 C) was suggestive of interstitial edema, while echocardiography on admission revealed features suggestive of left ventricular hypertrophy and global hypokinesia with ejection fraction of 40%. A nasopharyngeal swab for SARS-Cov-2 PCR was taken on admission, which came back positive.