MCA dot sign

Case contributed by Kwang Chin
Diagnosis almost certain

Presentation

Acute left upper and lower limb weakness

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

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MCA "dot" sign (arrow)

Annotated image

Magnified view demonstrating a hyperdense 'dot' in the anterior sylvian fissure. 

Case Discussion

The hyperattenuation of the MCA dot sign represents a thromboembolus within a segmental branch of the MCA located within the Sylvain fissure.  The sign appears when the high-attenuation MCA is viewed in cross-section, since the occluded vessel courses in a plane perpendicular to the transverse plane of imaging.

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