Presentation
Right arm weakness and aphasia. History of Takayasu vasculitis.
Patient Data
Age: 25 years
Gender: Female
From the case:
Left MCA stroke - dense MCA sign
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_pin":false},"extraPropsURL":"/studies/44873/annotated_viewer_json?iframe=true\u0026lang=us"}
Hyperdense left MCA. No acute intracranial hemorrhage. There is loss of grey-white matter differentiation in the region of the left lentiform and caudate nuclei. Mild left cerebral convexity sulcal effacement and subtle subcortical loss of grey-white differentiation. The ventricular pattern is normal. No midline shift.
Conclusion
Acute left MCA stroke.
Case Discussion
This case shows how subtle the loss of normal grey-white matter differentiation can be in early acute stroke. Without the dense MCA hitting you in the face, one might easily fly past the subtle parenchymal changes.