Hyperdense MCA sign

Case contributed by Dr Ahmed Abdrabou

Presentation

Left hemiparesis and dysarthria of sudden onset and progressive course

Patient Data

Age: 55 years
Gender: Male
CT

CT at presentation

Dense right middle cerebral artery signifying a thrombus inside the vessel. In this study there was no established infarction yet. Involutional brain changes are noted.

CT

Follow-up CT, next day

Follow-up study done the following day reveals established right MCA infarction with positive mass effect secondary to cytotoxic edema and hemorrhagic transformation. The hyperdense MCA can be still seen within the infarcted zone.

Case Discussion

The hyperdense vessel sign can be the earliest finding in patients with hyperacute stroke. Hence, careful examination of the vessels as regarding their course and density, with comparison with the other side, should be routine in non-contrast CT brain reporting.

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Case information

rID: 62019
Published: 28th Jul 2018
Last edited: 15th Aug 2019
Inclusion in quiz mode: Included
Institution: Ain Shams University

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