Acute left middle cerebral artery territory ischemic stroke

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Right sided weakness and confusion, onset two hours prior.

Patient Data

Age: 65
Gender: Male

Hyperdense left M1 segment. Mild hypoattenuation of the left caudate head. No intra- or extra-axial collection or hemorrhage demonstrated.

Perfusion defect in the left MCA territory with large infarct core but substantial surrounding ischemic penumbra.

Filling defect within the left distal ICA extending into the entire left M1 segment and proximal A1 segment. Poor opacification in the left M2 segment. ACA territory is perfused via the right ACA.

Case Discussion

Classical imaging features of acute ischemic stroke from proximal MCA occlusion. Unfortunately the infarct core was too large for consideration of neurointervention. 

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