Presentation
MVA, right sided hemiplegia.
Patient Data
Day 1: Hyperdense left intracranial ICA (cavernous and supraclinoid portions) & middle cerebral arteries.
18 Hours later: Large hypodense acute infarction in a left MCA distribution.
Day 2: Increased edema, hypodensity and mass effect of the infarction.
MRA: Occluded left internal carotid artery & collateral refilling of the left anterior cerebral artery via the ACOM.
Left MCA territory infarction showing diffusion restriction,
Note loss of signal void of the petrous, cavernous and supraclinoid portions of the left internal carotid artery.
Tapered occlusion of the proximal left internal carotid artery shortly after the carotid bifurcation.
Collateral refilling of the left anterior and middle cerebral arteries via circle of Willis.
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