Presentation
Right-sided hemiplegia and slurred speech for a few hours.
Patient Data
Hyperdense middle cerebral artery in the left Sylvian fissure. Left-sided insular cortex loss of grey-white matter differentiation, known as the loss of the insular ribbon sign. Poorly visualized putamen of the left globus pallidus.
There is loss of normal grey-white matter differentiation in the left MCA territory, with hypoattenuation in the frontotemporal and parietal areas on the left cerebral side.
Mild compression ipsilateral to the lateral ventricle and Sylvian fissure, with effacement of cortical sulci due to cytotoxic edema from infarction.
Case Discussion
This case illustrates early signs of acute ischemic stroke involving the middle cerebral territory including the loss of the insular ribbon sign and hyperdense MCA sign. Early identification of ischemic stroke allows for a wider array of treatment options to be available including thrombolysis and endovascular clot retrieval.
This case is submitted in collaboration with Dr. Abdulwahed Alfaqeeh.
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