Hyperdense middle cerebral artery sign

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

2 days post-op for knee replacement. Now acute right hemiplegia

Patient Data

Age: 80
Gender: Female

Hyperdense left MCA (arrow) = acute thrombo-embolism with changes of hyperacute infarct in MCA territory including loss of the insular cortical strip or ribbon (a very important early sign of cortical infarction)

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