Presentation
Acute onset right hemiparesis with altered conscious state. No significant medical history.
Patient Data
Age: 65 years
Gender: Male
From the case:
Hyperdense MCA sign - importance of fine slice interrogation
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On the repositioned orthogonal thick slices there is a macroadenoma of the pituitary and subtle hyperdensity of the right MCA. No hemorrhage or hypodensity in the supplied brain parenchyma. The hyperdense right MCA is obvious on the fine slices (original data set).
From the case:
Hyperdense MCA sign - importance of fine slice interrogation
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Filling defect within the right M1 in keeping with occlusive thrombus as shown on the non-contrast CT.
Case Discussion
This case exemplifies three important rules for interpretation of CT:
- Do not stop looking at the remainder of the study when you see obvious pathology ie a macroadenoma of the pituitary.
- Always interrogate the original fine slice data set (not just the pretty thick MPRs).
- Always read the clinical notes and correlate the CT findings with the clinical concern (in this case the macroadenoma is completely incidental).
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