PMC9812408_01
(A) The patient had severe dental caries and severe loss of upper and lower teeth, with multiple residual crowns and roots. (B) The panoramic image of oral cavity indicated multiple residual crowns and roots on both sides of mandible.
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F1
A 19-year-old girl visited the emergency room with sudden weakness of the right limb for 1 day, and thyrotoxicosis, progressive caries and alopeca for 4 years (Fig. 1A). The panoramic image of oral cavity indicated multiple residual crowns and roots on both sides of mandible (Fig. 1B).
(A and B) Initial head computed tomography scan showed acute intraventricular hemorrhage and cerebral infarction of left middle cerebral artery territory. (C and D) Initial brain magnetic resonance imaging: diffusion-weighted imaging found high signal on left middle cerebral artery territory, and apparent diffusion coefficient discovered low signal on the same part. (E and F) Magnetic resonance angiography showed occlusion of bilateral proximal portion of the anterior and middle cerebral arteries, and these occluded vessels are surrounded by numerous small vessels.
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F2
An initial head computed tomography (CT) scan was ordered for suspected stroke, which confirmed acute intraventricular hemorrhage and cerebral infarction of left middle cerebral artery territory (Figs. 2A-B). Diffusion-weighted imaging found a high signal on left middle cerebral artery territory (Fig. 2C), and apparent diffusion coefficient discovered low signal on the same part (Fig. 2D). Magnetic resonance angiography showed occlusion of bilateral proximal portion of the anterior and middle cerebral arteries (Figs. 2E-F).
(A and B) After 11 days of treatment, re-examination of head computed tomography indicated absorption of ventricular hemorrhage and disappearance of infarction lesions. (C and D) After 16 days of treatment, re-examination of head magnetic resonance imaging indicated disappearance of infarction lesions.
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F3
After 11 days of treatment, re-examination of head CT indicated absorption of ventricular hemorrhage (Figs. 3A-B). Sixteen days after admission, the patient's NIHSS was 0 and the signal of infarction lesion on MRI was weakened (Figs. 3C-D).