Multiple cerebral emboli from caseous necrosis of mitral annulus calcification


The MRI brain showed the embolic strokes.

So a search for central or cardiac source was performed.

Transthoracic echocardiography, transesophageal echocardiography, then finally a cardiac MRI to confirm the source of emboli.

Based on multiple imaging modalities the source of central embolic stroke is caseous necrosis of mitral valve annular calcifications causing multiple embolic strokes.