0
February 02, 2009, Vol 163, No. 2 >
Special Feature | February 02, 2009

Picture of the Month—Quiz Case FREE

Iván Sánchez Fernández, MD; Jurriaan M. Peters, MD
[+] Author Affiliations

Section Editor: Samir S. Shah, MD

More Author Information
Arch Pediatr Adolesc Med. 2009;163(2):179. doi:10.1001/archpediatrics.2008.520-a.
Text Size: A A A
Published online
Article
Figures
Comments

A 2-month-old, previously healthy infant developed partial seizures, eventually controlled by phenobarbital, levetiracetam, and lamotrigine. The results of imaging studies and metabolic workup were normal. He was born full term after an uncomplicated pregnancy and delivery to healthy parents of Indian descent. His development had been unremarkable.

At the age of 5 months, he had a left hemiparesis due to a right anterior cerebral artery stroke. At the age of 11 months, he presented with a right hemiparesis and focal right-sided seizures from a left middle cerebral artery stroke (Figure 1). The results of cardiologic evaluation, including cardiac ultrasonography, were normal. Extensive hematologic workup and genetic screening for a hypercoagulable state were unrevealing. Magnetic resonance imaging and the concurrent magnetic resonance angiogram prompted a conventional 4-vessel angiogram (Figure 2).

Place holder to copy figure label and caption
Figure 1.

T2-weighted fluid-attenuated inversion recovery magnetic resonance imaging of the brain. A hyperintense region with volume loss is seen in the right frontal lobe representing gliosis from prior stroke. Extensive hyperintensity and swelling over the left hemisphere indicates subacute ischemic stroke of the left middle cerebral artery territory.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.

Place holder to copy figure label and caption
Figure 2.

Arterial angiogram of the left internal carotid system. Findings are described in detail in the “Denouement and Comment” section.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.

What is your diagnosis?

Figures

Place holder to copy figure label and caption
Figure 1.

T2-weighted fluid-attenuated inversion recovery magnetic resonance imaging of the brain. A hyperintense region with volume loss is seen in the right frontal lobe representing gliosis from prior stroke. Extensive hyperintensity and swelling over the left hemisphere indicates subacute ischemic stroke of the left middle cerebral artery territory.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.
Place holder to copy figure label and caption
Figure 2.

Arterial angiogram of the left internal carotid system. Findings are described in detail in the “Denouement and Comment” section.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Special Feature
Picture of the Month—Diagnosis
Arch Pediatr Adolesc Med. 2009;163(2):180. doi:10.1001/archpediatrics.2008.520-b.
Articles Related By Topic
Picture of the Month—Quiz Case
JAMA Pediatr. 2013;167(6):581. doi:10.1001/jamapediatrics.2013.328a.
Related Topics
PubMed Articles
Variable presentations of postpartum angiopathy.
Stroke 2012;;43(3):670-6.
Posterior reversible encephalopathy syndrome.
J Intensive Care Med 2012;;27(1):11-24.
JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Scenario

Users' Guides to the Medical Literature
TIME Trial—Resolution

All results at
JAMAevidence.com >

© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems