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What Does My CT Scan Indicate?

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Posted on Fri, 5 Dec 2014
Question: My 87 year old mother has just had an heart valve replacement and post operative brain scan shows she has had 2 episodes of left sided weakness consistent with a TIA. A CT head showed subacute nonhemorrhagic infarct affecting the left ACA territory. She has temporary memory lapses. Mum lives in England and I live in Australia. Should I get home asap?
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Answered by Dr. Geldon Fejzo (47 minutes later)
Brief Answer:
I recommend an MRI

Detailed Answer:
Hello. I have been through your question and understand your concern.

The heart valve replacement is associated with some risk for cardioembolic brain infarcts, that is why she is under Warfarin wich is an anticoagulant to prevent such eventuality. Moreover she is taking also an antiplatelet drug (clopidogrel). Still, there is some possibility for brain damage from cardiac emboli.

In the left ACA territory infarct, I would expect some motor weakness in the right foot, which is not reported. While the left sided weakness, which is considered as TIA, should be further investigated with a cranial MRI. So, the MRI would better explain not only if those were really just TIAs, but also can estimate the time of the subacute ACA infarct and at last any possible relationship with the memory impairment.

Several studies report a 15-30% of brain stroke after a TIA or silent Brain Infarct (seen in MRI)
I would recommend a cranial MRI, and after that you can better judge on returning home.

Hope this answers your question, please feel free for further questions.

Wishing your mother good health
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Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Geldon Fejzo

Neurologist, Surgical

Practicing since :2009

Answered : 337 Questions

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What Does My CT Scan Indicate?

Brief Answer: I recommend an MRI Detailed Answer: Hello. I have been through your question and understand your concern. The heart valve replacement is associated with some risk for cardioembolic brain infarcts, that is why she is under Warfarin wich is an anticoagulant to prevent such eventuality. Moreover she is taking also an antiplatelet drug (clopidogrel). Still, there is some possibility for brain damage from cardiac emboli. In the left ACA territory infarct, I would expect some motor weakness in the right foot, which is not reported. While the left sided weakness, which is considered as TIA, should be further investigated with a cranial MRI. So, the MRI would better explain not only if those were really just TIAs, but also can estimate the time of the subacute ACA infarct and at last any possible relationship with the memory impairment. Several studies report a 15-30% of brain stroke after a TIA or silent Brain Infarct (seen in MRI) I would recommend a cranial MRI, and after that you can better judge on returning home. Hope this answers your question, please feel free for further questions. Wishing your mother good health