Subtle left middle cerebral artery territory stroke with dense MCA sign

Case contributed by Dr Craig Hacking

Presentation

Right arm weakness and aphasia. Hx Takayasu's vasculitis

Patient Data

Age: 25
Gender: Female

Hyperdense left MCA. No acute intracranial haemorrhage. There is loss of grey-white differentiation in the region of the left lentiform and caudate nuclei. Mild left cerebral convexity sulcal effacement and subtle subcortical loss of grey-white differentiation. The ventricular pattern are normal. No midline shift.

Conclusion

Acute left MCA stroke.

Case Discussion

This case shows how subtle to the loss of normal grey-white matter differentiation can be in early acute stroke. Without the dense MCA hitting you in the face, one might easily fly past the subtle parenchymal changes.

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Case information

rID: 41870
Case created: 23rd Dec 2015
Last edited: 23rd Dec 2015
Inclusion in quiz mode: Included

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