Robert J. Wityk, MD; Donna Lapeyrolerie, MD; Barry D. Stein, MD
Wityk R., Lapeyrolerie D., Stein B.; Rapid Brain Calcification after Ischemic Stroke. Ann Intern Med. 1993;119:490-491. doi: 10.7326/0003-4819-119-6-199309150-00008
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Published: Ann Intern Med. 1993;119(6):490-491.
Calcium deposition in the brain, readily detectable on computed tomographic (CT) scan, has many possible causes [1-6]. Calcification of an ischemic infarction is rare and is thought to occur months to years after the acute event [2, 5]. We describe a patient who had extensive brain calcification after ischemic stroke. Brain calcification in this patient occurred during a 6-week period in the setting of uremia and hyperphosphatemia.
A 63-year-old man with a history of hypertension, alcohol abuse, and renal failure (for which he received maintenance hemodialysis) was admitted after having left-sided weakness and slurred speech for 1 day. He recalled having a brief episode of numbness on the left side 1 week earlier. At the initial examination, he was lethargic and had severe dysarthria, left hemiplegia with hyper-reflexia, and left-sided sensory deficits. A head CT scan showed no lesions. Medications before admission included colchicine, 0.6 mg daily; epoetin alfa, 4000 U daily; calcitriol, 0.5 g twice a day; aluminum hydroxide tablets four times a day; and transdermal nitroglycerin. Laboratory findings at admission were as follows: urea nitrogen, 21.0 mmol/L (60 mg/dL); creatinine, 1040 mol/L (11.8 mg/dL); calcium, 2.54 mmol/L (10.2 mg/dL); and phosphate, 2.05 mmol/L (6.4 mg/dL). All medications were continued except aluminum hydroxide.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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