Presentation
Left-sided hemiparesis.
Patient Data
Initial CT brain
Extensive acute fronto-temporo-parieto-occipital infarct in the right MCA territory with gyral effacement. Ipsilateral MCA dot sign (M2 thromboembolus).
Old lacunar infarct in left frontal corona radiata.
Small, old infarct in right cerebellar hemisphere.
Calcified plaque in cavernous segment of ICA bilaterally.
Subacute right MCA territory infarct with severe surrounding edema exerting mass effect on the right ventricle and subfalcine herniation.
Gyriform hyperdensity in the infarct territory represents petechial hemorrhagic infarction and fogging.
Numerous linear and punctate foci of hemorrhagic transformation.
Case Discussion
This case exemplifies, in the same patient, the appearance of
- acute MCA territory infarct with MCA dot sign
- subacute MCA infarct with laminar necrosis
- eventual hemorrhagic transformation thereof
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