CTA Neck
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0393-CTA Neck
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CA0393-CTA Neck
Case ReportExam
Prior Study
Changes consistent with hyperacute stroke in the Lt lateral lenticulostriate and the Lt. superior division MCA regions. This makes the likely level of occlusion in the Lt. M1/2 superior division MCA segment.
No intracranial hemorrhage nor hyperdense (acute) thrombotic arterial segments are evident.
CT Perfusion
Acute stroke changes with focal prolonged TTP and MTT plus moderate reduction in CBF and CBV centered in the Lt orbitofrontal artery with some involvement of the Lt. rostral lentriculostriate, and Lt. anterior insular M3 perfusion zones. The tissue at risk is surrounded by areas of physiological hyperemia.
Findings
CTA of the neck
Extradural carotids and Lt. vertebral arteries are normal for age.
Rt. vertebral artery has a short segment stenosis at it origin in the 50% NASCET range, but there is early post-stenotic dilatation, which suggests the stenosis grade is slightly higher. This stenosis accounts for the perfusion delay evident in the Rt. cerebellum on the CT perfusion.
Impression
2. No arterial occlusive disorder is event on neck CTA to account for the apparent stroke in the left cerebrum on noncontrast CT and CT perfusion.
3. There is nonspecific hypertrophy of the pharyngeal tonsillar tissue. There is no dominant mass, but this degree of tonsillar hypertrophy is unusual for a patient of this age.
Recommendations
Call the clinical service in reference to the unexplained pharyngeal tonsillar hypertrophy
