Extensive cerebral infarct in a child with Tetralogy of Fallot

Case contributed by Dr Abiola Ayodele

Presentation

Right hemiplegia.

Patient Data

Age: 3 years
Gender: Male

There is an extensive area of T2/FLAIR hyperintensities with restricted diffusion on DWI and corresponding ADC involving the entire left cerebral hemisphere. No blooming artefact on Gradient echo sequence.

There is also ischemic changes involving the anterior corpus callosum, crossing to the right and inferior right frontal lobe. 

There is associated effacement of the sulci, gyri and left lateral ventricle. 

Midline shift to the right is also noted.

Case Discussion

Cerebral infarct is a possible complication of tetralogy of Fallot. This case demonstrates acute cerebral infarction involving the entire left cerebral hemisphere, anterior corpus callosum and inferior right frontal lobe likely cardioembolic. MRA TOF may show multiple vascular occlusions, though it was not available for this case.

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Case information

rID: 88311
Published: 7th Apr 2021
Last edited: 8th Apr 2021
Inclusion in quiz mode: Included
Institution: Lagos state university teaching hospital

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