Left MCA territory infarct - evolution

Case contributed by Maxime St-Amant
Diagnosis certain

Presentation

Right-sided weakness. Expressive dysphasia. Query stroke.

Patient Data

Age: 65 years
Gender: Male
  • left M2 branch hyperdensity
  • grey-white matter differentiation loss in the left MCA territory: posterior insular ribbon, frontal operculum and upwards at the frontoparietal convexity (pre- and post-central gyrus involvement), body of the left caudate nucleus

6 hours later

ct
  • increased grey-white matter differentiation loss and hypodensities in the previously described left MCA territory, including the body of the left caudate nucleus
  • increased mass effect with partial sulcal effacement
  • left M2 branch hyperdensity is persisting

48 hours later

ct
  • increased hypodensities involving a larger part of the left MCA territory
  • increased mass effect with sulcal effacement and left lateral ventricle compression
  • no evidence of hemorrhagic transformation

Case Discussion

This case well depicts the short-term evolution of a left MCA territory infarct.

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