MCA infarction

Case contributed by A.Prof Frank Gaillard

Presentation

Acute onset left sided weakness.

Patient Data

Age: 65 years
Gender: Female

CT brain

Modality: CT

The right MCA is hyperdense and there is subtle blurring of the grey white matter junction of the inuslar cortex and lentiform nucleus. 

CTA and perfusion

Modality: CT

CTA confirms left M1 occlusion. Perfusion demonstrates a sizable mismatch between CBF and TMax, implying a sizable penumbra.  

Attempted clot retrieval

Modality: DSA (angiography)

Attempted clot retrieval was performed, however the M1 segment could not be adequately recanalised. 

CT brain 2 days later

Modality: CT

The area show to be 'at risk' on perfusion has gone on to infarct.

Case Discussion

Typical appearances of an acute MCA infarct with evolution following unsuccessful reperfusion. 

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Case Information

rID: 21459
Case created: 24th Jan 2013
Last edited: 4th Oct 2015
Inclusion in quiz mode: Included

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