CT - CT done at 4 hours, with a subsequent followup 24 hours CT
Axial non-contrast
Axial non-contrast
what are the early signs of MCA infarction in CT?
1. Loss of insular ribbon sign (LIR) 2. Disappearing basal ganglia sign 3. Obscuration lentiform nucleus sign 4. Hyperdense MCA sign
CT done within 4 hours demonstrates the blurring of grey white matter differentiation at the left insular cortex, with loss of the insular ribbon, obscuration of the lentiform nucleus and abnormally hypodense left basal ganglia showing absence of normal contour (disappearing basal ganglia sign).
CT repeated at 24 hours, (after thrombolytic therapy) reveals more prominent hypoattenuating left basal ganglia and insular cortex, as the infarct has matured.