A 35 years old male, presented with sudden onset left hemiparesis. Over the next 24 h, he developed a generalized tonic-clonic seizure and progressive obtundation of sensorium. There was no history of preceding a transient ischemic attack, headache, fever, trauma, hypertension or diabetes mellitus. Examination He was normotensive, stuporous and pupils were equal in size and reaction. He had left sided hemiparesis and extensor plantar reflex bilaterally.
Computerised tomography (CT) scan of the brain revealed bilateral frontal, temporopareital and occipital ischemic infarcts with hemorrhagic transformation. Magnetic resonance imaging (MRI) of brain confirmed these findings. MR Arteriography (MRA) and venography (MRV) did not show any evidence of vascular thrombosis. In view of his neurological status, he was subjected to a limited water deprivation test. Over three hours of absolute…
