{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T01:02:23Z","timestamp":1788829343992,"version":"build-2803163510"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background and Purpose\u2014<\/jats:italic>\n            <\/jats:bold>\n            Unenhanced head CT has become the first line imaging study in the evaluation of suspected acute cerebral ischemia. It is important to identify subtle findings of acute ischemia on this exam to direct appropriate patient management.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Summary of Case\u2014<\/jats:italic>\n            <\/jats:bold>\n            We report the first case of multiple pial surface distal internal carotid artery territory calcified emboli causing multifocal cerebral infarctions, likely from a carotid bifurcation source.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            Visualization of multiple pial surface calcifications on unenhanced head CT, the \u2018salted pretzel sign\u2019, should raise suspicion for acute infarction from showered calcific emboli.\n          <\/jats:p>","DOI":"10.1161\/strokeaha.108.538009","type":"journal-article","created":{"date-parts":[[2009,3,13]],"date-time":"2009-03-13T02:07:37Z","timestamp":1236910057000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Showered Calcific Emboli to the Brain, the \u2018Salted Pretzel\u2019 Sign, Originating From the Ipsilateral Internal Carotid Artery Causing Acute Cerebral Infarction"],"prefix":"10.1161","volume":"40","author":[{"given":"Brett A.","family":"Christian","sequence":"first","affiliation":[{"name":"From the University of Tennessee Medical Center, Knoxville, Tenn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Kirzeder","sequence":"additional","affiliation":[{"name":"From the University of Tennessee Medical Center, Knoxville, Tenn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Boyd","sequence":"additional","affiliation":[{"name":"From the University of Tennessee Medical Center, Knoxville, Tenn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffery","family":"Laing","sequence":"additional","affiliation":[{"name":"From the University of Tennessee Medical Center, Knoxville, Tenn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judson R.","family":"Gash","sequence":"additional","affiliation":[{"name":"From the University of Tennessee Medical Center, Knoxville, Tenn."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000083400.80296.38"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000314686.94007.d0"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.27.5.847"},{"key":"e_1_3_2_4_2","first-page":"1996","volume":"27","year":"2006","unstructured":"Kavanagh EC, Fenton DM, Heran MKS, Lapointe LS, Nugent RA, Graeb DA. Calcified cerebral emboli. AJR Am J Roentgenol. 2006; 27: 1996\u20131999.","journal-title":"AJR Am J Roentgenol"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000195152.46506.3e"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon199444241"},{"key":"e_1_3_2_7_2","first-page":"1467.","volume":"174","year":"2000","unstructured":"Khaw N, Gailloud P. CT of calcific cerebral emboli after carotid manipulation. AJR Am J Reontgenol. 2000; 174: 1467.","journal-title":"AJR Am J Reontgenol"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-198104000-00009"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2411040573"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2004.tb00270.x"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.108.538009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T12:43:15Z","timestamp":1715604195000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.108.538009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,5]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2009,5]]}},"alternative-id":["10.1161\/STROKEAHA.108.538009"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.108.538009","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,5]]},"assertion":[{"value":"2008-10-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2008-11-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-03-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}