Presentation
Headache and right lower nasal quadrantinopia. Subsequent collapse to the floor while in A&E with right hemiparesis.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/13207/annotated_viewer_json?lang=us"}
Non contrast CT of the brain demonstrates a hyperdense left MCA artery.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/13208/annotated_viewer_json?lang=us"}
The MCA territory infarct has become established and there is a slight hemorrhagic transformation of the left basal ganglia.
The left internal carotid artery tapers after the bulb with a 'rat tail' appearance. On T1 images, the ICA is thickened and with high T1 signal suggesting dissection with occlusion up to the level of the ophthalmic artery. An M1 filling defect is present suggesting an artery to artery embolus.
Case Discussion
This case illustrates the importance of the hyperdense MCA sign on the initial CT scan.
Unable to process the form. Check for errors and try again.