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Acute right middle cerebral artery territory infarct with temporal evolution

Case contributed by David Clemo Steel
Diagnosis certain

Presentation

2 hours of sudden left hemiparesis.

Patient Data

Age: 20
Gender: Male

Hyperdense right MCA sign and discretely hypodense right parenchyma with loss of gray-white matter differentiation. 

After 24 hrs and thrombolytic therapy, there is extensive hypodensity and further loss of grey-white differentiation in the right MCA territory. Also, there is positive mass effect with partial effacement of the right lateral ventricle. 

Case Discussion

Large MCA thrombi have poor outcomes, even with thrombolytic therapy.

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