Bilateral acute middle cerebral artery territory infarcts

Case contributed by Dr Ian Bickle

Presentation

GCS 5/15. Intracranial hemorrhage?

Patient Data

Age: 75 years
Gender: Male

Hyperdense middle cerebral arteries in the M2 segments, consistent with clot.  This is more evident on the left.

No parenchymal changes of infarction. No hemorrhage.

Extensive bilateral avid diffusion restriction in both cerebral hemispheres, in the territory of the middle cerebral arteries, with sparing of the basal ganglia. No hemosiderin deposition.

Normal appearances of the posterior fossa.

Case Discussion

Appearances in keeping with bilateral acute MCA territory infarcts.

The territories of the lateral lenticulostriate arteries are spared.

The appearances are striking and the synchronous duality is uncommon.

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Case information

rID: 77319
Published: 13th May 2020
Last edited: 8th Jan 2021
Inclusion in quiz mode: Included

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