Middle cerebral artery territory infarct

Case contributed by Subash Thapa
Diagnosis certain


Left hemiparesis and sudden decrease level of consciousness.

Patient Data

Age: 75 years
Gender: Female

CT Brain


There is a large wedge-shaped hypoattenuating area involving the right cerebral hemisphere with loss of gray-white matter differentiation and effacement of the ipsilateral Sylvian fissure, cortical sulci and the lateral ventricle. There is evidence of “hyperdense MCA” sign on the right side. There is decreased density of the right basal ganglia s/o “disappearing basal ganglia” sign.

Case Discussion

Features of right middle cerebral artery territory infarct with hyperacute acute thrombus in the right middle cerebral artery.

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