Left MCA infarct
Acute onset right sided paraparesis with a right sided homonymous hemianopia.
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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.
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.