title: Calcific emboli originating from the brachiocephalic trunk causing acute cerebral infarction and worm-like calcification in the right middle cerebral artery.
abstract: We report, to our knowledge, the first patient with brachiocephalic trunk calcified plaque causing the 'salted pretzel sign' and worm-like calcification. Arterial stenosis or occlusion caused by atherosclerosis and thrombosis are responsible for the majority of cases of cerebral infarction. However, there are a number of other causes. Interestingly, these findings were not observed on a CT scan 10 days before the stroke. Acute cerebral infarction with calcifications on unenhanced head CT scans should raise suspicion for disease in the carotid system. Identification of subtle findings of acute ischemic stroke on CT scans is important for early diagnosis and treatment.
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, 12 Middle Urmqi Road, Jing'an District, Shanghai 200040, China.
authors.forename: Qiuqiong
authors.initials: Q
authors.lastname: Deng
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, 12 Middle Urmqi Road, Jing'an District, Shanghai 200040, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, 12 Middle Urmqi Road, Jing'an District, Shanghai 200040, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Ding
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, 12 Middle Urmqi Road, Jing'an District, Shanghai 200040, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Dong
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, 12 Middle Urmqi Road, Jing'an District, Shanghai 200040, China; Department of Neurology, Pudong Hospital, Shanghai, China. Electronic address: jianhuifu@126.com.
authors.forename: Jianhui
authors.initials: J
authors.lastname: Fu
mesh_terms: D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000209:etiology; D004617:Embolism / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011859:Radiography; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: Calcific emboli; Cerebral infarction; Salted pretzel sign; Worm-like calcification