Stone cold stroke: A case report of calcific emboli in an ischemic stroke

Ischemic strokes occur due to a reduction in blood flow to the brain, typically from an occluded artery. Embolic strokes are a subset where the blockage is caused by dislodged thrombus that travels from distal areas of the body, such as the heart or large arteries, and lodges in a cerebral vessel, leading to localized ischemia. While emboli are common causes of ischemic strokes, calcific emboli causing an ischemic stroke are much less reported and are frequently underdiagnosed. We report here a case of a patient with stroke symptoms who was found to have a carotid plaque on imaging, who then acutely worsened after admission, and subsequently found to have numerous new calcified emboli on a follow-up head CT.