A patient had - down

[ArchivalUser]

A patient had diabetes, his BP is 200/100, he was brought to emergency with paralysis of one side of his body, In CT scan, there is cystic space in the brain. What is your diagnosis?
a. Intracerbral hemorrhage
b. embolic stroke
c.atherosclerotic stroke
d.lacunar stroke
e.ruptured berry aneurysm
f.epidural hematoma
g. subdural hematoma

[ArchivalUser]

C.

[ArchivalUser]

eee

[ArchivalUser]

pt has adult policistic kidnet dis is associated with berry aneurism

[ArchivalUser]

answer is C. cystic areas of microinarction less than 1 cm in diameter. Lacunar stroke is caused by hyaline arteriolosclerosis secondary to either hypertension or diabetes mellitus.

why not following:
a. Intracerebral hge: lenticulostriate vessel, develope charcot bouchard aneurysm due to HTN, rupture cause hge, common site basal ganglia, or thalamus or pons and cerebellar hemisphere. will show hge in CT.
b. embolic stroke: most MCA, hemorrhagic infarction, wedge shaped in the periphery, no relation here.
c.atherosclerotic/thrombotic: MCA, platelet thrombi develop on top of thrombi, no reperfusion, so no hge, remain pale, loss of demarcation between gray and white matter, at the periphery of cerebral cortex (liquefactive necrosis), in CT it didnt say anything about hge.

e. ruptured berry: subarachnoid hge, worst headache, didnt give such history,

f. epidrual: middle meningeal, lucid interval, no such history here
g. subdural: bridging vein, result of trauma common, clot over convexity of brain,if left untreated, dementia, hernia , death, no such history or CT.

[ArchivalUser]

sorry, typo, answer is d, lacunar stroke.

[ArchivalUser]

d.lacunar stroke

Good qs, tnx

[ArchivalUser]

guys.. where do we see ring hemorrhage??

[ArchivalUser]

isnt it toxoplasmoxis____________

[ArchivalUser]

toxoplasma... i think comes with calcification or ring shadow on ct. not hg.