Middle cerebral artery territory infarct

Case contributed by Dr Ian Bickle


Acute left sided hemiplegia, but beyond the 4.5 hour time interval for thrombolysis.

Patient Data

Age: 55 years
Gender: Male

Hyperdense left MCA - from M2 segment in Sylvian fissure distally.

Diffuse low attenuation in the left MCA territory. No hemorrhage.

Multiple basal ganglia and thalamic lacunar infarcts.


Large T2/Flair hyperintensity area with restricted diffusion in the left middle cerebral artery territory.

MRA reveals no signal in the left middle cerebral artery, from M2 segment onward.


Case Discussion

Good example on CT and MRI of an acute complete left MCA territory infarct with left MCA occlusion due to thrombus, evidenced by the MCA dot sign.


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