Calcified left middle cerebral artery embolism

Case contributed by Frank Gaillard


Acute right hemiparesis.

Patient Data

Age: Elderly

A markedly hyperdense focus is seen in the sylvian fissure (calcified on ROI density measurement). 

CT brain - 2 days later


MCA territory infarct with hemorrhagic transformation has developed with further patchy change in the anterior cerebral artery territories, bilaterally. 

Case Discussion

This case illustrates the appearance of a hyperdense, calcified embolism. It is important to recognize this as it is a marker of poor response to IV thrombolytic therapy and a contraindication of clot retrieval / angioplasty due to the risk of vessel rupture. 

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