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Acute MCA territory infarct

Case contributed by Dr Alexandra Stanislavsky

Presentation

Altered conscious state

Patient Data

Age: 70 years
Gender: Male
CT

The left middle cerebral artery is hyperdense (M1 segment) and the superior part of the head and the body of caudate as well as the lentiform nucleus are hypodense, difficult to distinguish from the adjacent white matter. Similarly the insular cortical ribbon and part of the frontal lobe operculum have lost normal grey white matte differentiation. There is no swelling or hemorrhage. 

Annotated image

Hypodensity and loss of grey white matter differentiation of the superior head and body of caudate (blue arrow), lentiform nucleus (yellow arrow) and of the insular cortex and adjacent frontal operculum (red arrows). 

Hyperdence MCA sign is present on the left (green arrow) representing the intraluminal thrombus.  

Case Discussion

This case illustrates the typical appearances of an acute middle cerebral infarct. 

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