Left MCA infarct

Case contributed by Dr Jeremy Jones

Presentation

Acute onset right sided paraparesis with a right sided homonymous hemianopia.

Patient Data

Age: 45 years
Gender: Female
CT

CT brain

Hyperdense MCA sign (thrombus within the MCA) and peripheral low attenuation of the supplied MCA territory with loss of grey-white differentiation. Features of an MCA territory infarct.

Case Discussion

Typical appearances of an a relatively large and established MCA (middle cerebral artery) infarct with thrombus visualised in the proximal MCA (hyperdense MCA sign).

A subsequent CT (not uploaded) confirmed marked deterioration within 24 hours and a craniotomy was performed to facilitate decompression.

Large vessel occlusion from thrombus is atypical in this age group (45 year old female) and an underlying coagulopathy was suspected, but not found.

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Case information

rID: 5105
Case created: 4th Dec 2008
Last edited: 2nd Aug 2016
Inclusion in quiz mode: Included

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