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Washington University Experience | VASCULAR | Small Vessel Disease | 16A0 Case 16 History
Case 16 History ---- The decedent was a 59-year-old woman with a past medical history of poorly controlled type 2 diabetes mellitus, hyperlipidemia, hypertension, transient ischemic attacks and anemia who presented to an OSH ED with altered mental status. Prior to this presentation she was being evaluated for postmenopausal bleeding, hematuria and was found to have a large pelvic mass which seemed to be arising from the uterus and was concerning for malignancy. She was also being treated for an UTI with antibiotics. CT scan of the head at admission was negative for acute ischemia. As an attempt was made to move her from bed to a wheelchair to perform an endometrial biopsy, she had a seizure with brief loss of consciousness and bradycardia. Later that day, while getting a brain MRI, she became unresponsive and was found to be in pulseless electrical activity. MRI showed acute infarction in the right cerebellum, as well as the subcortical white matter of the right frontal and parietal lobes. ---- At autopsy the weight of the unfixed brain was 1120 grams. There were several areas of focal gray discoloration of the subcortical white matter in the right parietal lobe which represent microinfarcts and hyaline arteriosclerosis.
