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A 78-year old man presented with left hemiparesis of 90 minutes duration. A diagnosis of right MCA territory infarct was made and he was started on tissue plasminogen activator infusion for thrombolysis. 54 minutes after starting infusion, he developed swelling involving left side of tongue. t-PA infusion was stopped. A diagnosis of oro-lingual edema wasContinue reading “ANGIOEDEMA AFTER tissue PLASMINOGEN ACTIVATOR INFUSION”


Large Vessel Stroke as Presenting Feature of Covid 19 Dr Sudhir Kumar MD DM, Consultant Neurologist, Apollo Hospitals, Hyderabad COVID-19 caused by SARS CoV2 is a global pandemic, which has affected about 3 million people worldwide, and has resulted in more than 2,00,000 deaths. Respiratory system seems to be the main target of COVID-19Continue reading “LARGE VESSEL STROKE AS PRESENTING FEATURE OF COVID-19”


How does COVID 19 affect Nervous System? Covid 19, caused by SARS CoV2 virus, is a global pandemic, which has infected about 1.88 million people in about 200 countries, resulting in about 1,16,800 deaths. Covid 19 predominantly affects respiratory system. Common symptoms include fever, cough, breathing difficulty, fatigue and chest pain. Severe cases manifest withContinue reading “HOW DOES COVID 19 AFFECT THE NERVOUS SYSTEM”

Hyperdense MCA sign in Acute Ischemic Stroke

55-year old gentleman, known diabetic and hypertensive presented with symptoms of right hemiplegia and aphasia of three hours duration. He was evaluated for possible thrombolytic treatment. CT brain done (3.5 hours after stroke symptom onset) showed a dense (also referred to as hyperdense) MCA sign (yellow arrow in the 1st image). Thrombosis of middle cerebralContinue reading “Hyperdense MCA sign in Acute Ischemic Stroke”

THE DENSE PCA SIGN-Posterior Cerebral Artery Visualised on CT Scan

Dense or hyperdense MCA (middle cerebral artery) sign is a well recognized sign of early ischemia and is associated with large infarctions in MCA territory. Dense PCA sign is not so well recognized, however, it can be seen in about 35% of all cases of PCA territory infarction. It is typically located in ambient cistern,Continue reading “THE DENSE PCA SIGN-Posterior Cerebral Artery Visualised on CT Scan”

Alexia Without Agraphia in a Case of Stroke

50-year old gentleman presented with acute onset inability to read (alexia). However, he was able to write (he had no agraphia). On dictation, he could write on paper, however, he was not able to read what he had written. This clinical syndrome is called “alexia without agraphia” or pure alexia. MRI brain showed an acuteContinue reading “Alexia Without Agraphia in a Case of Stroke”

Acute Subdural Hematoma mimicking a stroke

87-year old gentleman was brought to OPD with complaints of right-sided weakness and inability to speak of 48-hours duration. He was apparently well prior to that. He had earlier been treated for cardiac disease, however, details were not known. There was no history of head trauma. On examination, he was conscious, however, had global aphasia.Continue reading “Acute Subdural Hematoma mimicking a stroke”