Presentation
Left hemiparesis and dysarthria of sudden onset and progressive course
Patient Data
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.
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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