Presentation
Acute right hemiparesis.
Patient Data
Age: Elderly
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A markedly hyperdense focus is seen in the sylvian fissure (calcified on ROI density measurement).
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MCA territory infarct with hemorrhagic transformation has developed with further patchy change in the anterior cerebral artery territories, bilaterally.
Case Discussion
This case illustrates the appearance of a hyperdense, calcified embolism. It is important to recognize this as it is a marker of poor response to IV thrombolytic therapy and a contraindication of clot retrieval / angioplasty due to the risk of vessel rupture.