Two cases of cerebral infraction diagnosed as calcified cerebral emboli

Abstract

We report two cases of stroke with calcified cerebral emboli (CCE). Case 1 was a 76 years old woman who experienced stroke with right hemiplegia. Non-contrast enhanced cranial computed tomography (CT) and magnetic resonance imaging on admission showed acute stroke and CCE in the branches of the left middle cerebral artery (MCA). A calcified plaque was seen as mitral annular calcification (MAC) on echocardiography. No other plaque was seen on echo and CT, so we identified MAC as the source of the emboli. Case 2 was 92 years old woman who experienced stroke with right hemiplegia and disturbance of consciousness. Non-contrast enhanced CT showed acute stroke and CCE in the branches of the MCA and a chest CT showed aortic arch calcification. We identified as aortic arch calcification as the source of the emboli. In these cases, ultrasound examination and CT were useful for the diagnosis of CCE. Since CCE is difficult to diagnose, further investigations are recommended.