Ischemic stroke

Discussion:

Non-enhanced CT scan is the initial step to rule out intracranial hemorrhage during a 'stroke call', and can demonstrate some clear signs of ischemic stroke.

This case illustrates the classic signs of middle cerebral artery territory infarct, such as the loss of the insular ribbon sign, the hyperdense MCA sign, and loss of gray-white matter differentiation. Adjusting the window and level (e.g. W:40 L:40 or W:8 L:32) is used for optimized visualization of subtle loss of gray-white matter differentiation.

Restriction diffusion on DWI and ADC maps are in-keeping with extensive acute ischemic infarction of left middle cerebral artery territory.

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