Left middle cerebral artery branch embolus causing stroke

Case contributed by Dr Chris O'Donnell

Presentation

Conscious collapse with acute right hemiplegia and disruption of speech.

Patient Data

Age: 70
Gender: Male

Subtle but definite filling defect in a left middle cerebral artery trifurcation branch leading to reduced perfusion to the left cerebrum (as evidenced by prolonged time to maximum contrast density i.e. Tmax). Carotid bifurcations are normal.

Case Discussion

Acute stroke is often due to embolism in a MCA branch. This can be detected by early CT angiography of the circle of Willis. The effects on brain perfusion can also be demonstrated by CT perfusion studies and the common carotid bifurcations assessed for atheromatous plaque and luminal narrowing; being a common source for such emboli.

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Case Information

rID: 36518
Case created: 27th Apr 2015
Last edited: 15th Dec 2016
Inclusion in quiz mode: Included

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