Left MCA infarction

Case contributed by Dr Jeremy Jones

Presentation

Headache and right lower nasal quadrantinopia. Subsequent collapse to the floor while in A&E with right hemiparesis.

CT

CT brain

Non contrast CT of the brain demonstrates a hyperdense left MCA artery. 

MRI

MRI brain

The MCA territory infarct has become established and there is slight haemorrhagic transformation of the left basal ganglia. 

The left internal carotid artery tapers after the bulb with a 'rat tail' appearance. On T1 images there the vessel is thickened and with high T1 signal suggesting dissection with occlusion up to the level of the ophthalmic artery. An M1 filling defect is present suggesting an artery to artery embolus. 

Case Discussion

This case illustrates the importance of the hyperdense MCA sign on the initial CT scan. 

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Case information

rID: 13190
Case created: 11th Mar 2011
Last edited: 4th Oct 2015
Tag: stroke
Inclusion in quiz mode: Included

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