Middle cerebral artery dot sign

Case contributed by Dr Ian Bickle


Young cardiomyopathy patient presents with a short history of right sided paresis.

Patient Data

Age: 29
Gender: Female
Modality: CT

The M2-M3 segment of the left middle cerebral artery in the distal Sylvian fissure is hyperdense.   It has a bright 'dot like' like appearance on the axial images.

Little, if any, abnormality of distal brain parenchyma.

MRI abandoned due to lack of patient cooperation. 5 days later a repeat CT brain was undertaken.

Modality: CT

Relatively subtle low attenuation in the left temporoparietal region, in the distribution of the posterior branch of the MCA.

No haemorrhage.

Modality: Photo

Illustration of the anatomical arterial supply of the brain to illustrate the nature of the findings on the CT brain.

Thanks to Frank Gaillard for illustrations.

Case Discussion

A decent example of the MCA dot sign - the consequence of thrombus in the middle cerebral artery.

Subsequent end organ damage in the form of a posterior branch MCA artery territory infarct is illustrated.

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Case Information

rID: 44812
Case created: 5th May 2016
Last edited: 19th Dec 2016
Inclusion in quiz mode: Included

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