As our patient had spontaneous hemorrhagic transformation in a large embolic infarct
(both of which are associated with increased risk of further hemorrhage), we opted not to initiate full anticoagulation.
A CT of the head without contrast was performed due to his altered mental status, which showed two areas concerning embolic infarcts
in the left parietal lobe and the left cerebellum (Figure 1(b)), compared to the one obtained on admission.
A repeat head CT scan revealed multiple acute embolic infarcts
in the bilateral posterior temporal lobes, left occipital lobe, and posterior right middle cerebral artery involving the parietal and temporal lobes (Figure 1(b)).
AP was taken for an emergent MRI that revealed a large left MCA territory infarct with multiple embolic infarcts
in the bilateral anterior cerebral artery territories and right MCA territory (Figure 2).