Anterior circulation infarct - malignant

Case contributed by Hidayatullah Hamidi
Diagnosis certain

Presentation

Unconscious state for last two days.

Patient Data

Age: 75 years
Gender: Female

Motion artifact noted.

Diffuse swelling of left cerebral hemisphere demonstrating T2/FLAIR high signal, T1 low signal, and diffusion restriction.

Effacement of left lateral ventricle, midline shift of approximately 15 mm towards the contralateral side and evidence of acute dilatation of right lateral ventricle.

Time-of-flight images show absence of flow in left internal carotid artery, as well as left anterior, middle and posterior cerebral arteries.

Case Discussion

Features are representative of left anterior circulation acute infarct involving the entire left cerebral hemisphere.

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