Presentation
4 days history of confusion and worsening balance. On examination, he is hypertensive but has no focal infective signs. He appears to have a homonymous hemianopia on visual field examination
Patient Data
Subtle hypodensity of left occipital lobe with loss of grey-white differentiation. A focal hyperdensity of P2 segment of the left posterior cerebral artery is noted.
CT intracranial angiography study a week later revealed a well-established left posterior cerebral artery territory infarct with thrombosis of P2 segment of left posterior cerebral artery.
Case Discussion
The hyperdense artery sign refers to focal hyperdensity in an artery (in this instance the posterior cerebral artery) on non-contrast brain CT and is the direct visualization of thromboembolic material within the lumen. It is thus the earliest visible sign of PCA infarction.
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