Traumatic ICA thrombosis with cerebral infarction

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Left hemiplegia 48 hours following cervical trauma (contact sports).

Patient Data

Age: 35 years
Gender: Male

Large infarct in the distribution of the right middle cerebral artery territory eliciting a low signal on T1, high signal on T2 and FLAIR with restricted diffusion and area of hemorrhagic component on GE sequence. A mass effect is noted on the midline structures.

MRA (source images and 3D TOF) shows extensive thrombosis of the right internal carotid artery extending from the carotid bifurcation up to its terminal intracranial segment as well as the middle cerebral artery. The axial T1 fast sat sequence shows a high signal material filling the vascular lumen of the internal carotid artery.

Case Discussion

MRI features of extensive thrombosis of the right internal carotid artery with MCA infarction in a patient with a history of cervical trauma (contact sports).

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