Right MCA acute infarction with hyperdense sign

Case contributed by Dr Andrew Van


Unwitnessed fall, found unconscious. Left upper and lower limb hypertonia, nil power.

Patient Data

Age: 50 years old
Gender: Male

Large area of cortical and deep white matter low density is observed in the right frontal lobe with effacement of the sulci in this region, appearances being typical of acute infarction. Extensive hyperdensity of the middle cerebral artery is consistent with thrombosis. 

The large infarct is causing relatively mild mass effect with compression of the right lateral ventricle but no midline shift or compartment herniation. Basal subarachnoid cisterns are preserved. 

Case Discussion

Right hyperdense MCA sign consistent with acute ischaemic stroke.

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Case information

rID: 45168
Published: 16th May 2016
Last edited: 1st Dec 2016
Inclusion in quiz mode: Included

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