A case of acute ischemic stroke complicating with crowned dens syndrome

Abstract

A 75-year-old woman became speechless and was brought to the emergency room. She was diagnosed with ischemic stroke on the left middle cerebral artery territory. She also had a high fever of 38°C associated with stiff neck. Cerebrospinal fluid examination showed normal initial pressure and cell number indicating exclusion of encephalitis and meningitis. Neck CT revealed the calcifications in the vertebral axis dens backwards. She was diagnosed with crowned dens syndrome which is a pseudogout of cervical spine. This is an educational case to show the significant source of crowned dens syndrome associated with fever on acute stroke.