Spontaneous calcific cerebral emboli from calcified aortic valve stenosis

Calcific cerebral emboli (CE) are a rare complication of calcified aortic valve stenosis (CAS). These emboli usually result from diagnostic manoeuvres (e.g. left heart catheterization) or from therapeutic procedures (e.g. heart valve surgery). Spontaneous calcific emboli are exceptional. We present the cases of two subjects known to have CAS who presented with acute neurological disorders suggesting strokes. In both subjects CT scans of the skull and brain provided a diagnosis of spontaneous CE by showing calcium-dense dots located on vessels or within the cerebral parenchyma. Additional examinations enabled us to determine the origin (heart or carotid artery) of these emboli. The finding of spontaneous cerebral CE is a very strong argument in favour of surgical valve replacement in these patients.