IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Acute ischemic stroke: dense MCA sign

Case contributed by Gaurav Som Prakash Gupta
Diagnosis certain

Presentation

Sudden onset right-sided weakness and aphasia.

Patient Data

Age: 80 years
Gender: Female

Image clearly demonstrates:

  • dense MCA sign on the left
  • insular ribbon sign

CT also show hypodensity with loss grey-white matter differentiation in the left MCA territory.

Follow up CT showed sell established left MCA infarct.

Case Discussion

This case illustrates early signs of infarction. Although in this case the parenchymal hypodensity is well seen, however, in patients with an earlier presentation, the dense MCA sign and insular ribbon sign may be the only evidence of infarction and prompt either CT perfusion or MRI to determine the feasibility of thrombolytic therapy. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.