Presentation
Conscious collapse with acute right hemiplegia and disruption of speech.
Patient Data
Age: 70
Gender: Male
From the case:
Left middle cerebral artery branch embolus causing stroke
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Subtle but definite filling defect in a left middle cerebral artery trifurcation branch leading to reduced perfusion to the left cerebrum (as evidenced by prolonged time to maximum contrast density i.e. Tmax). Carotid bifurcations are normal.
Case Discussion
Acute stroke is often due to embolism in a MCA branch. This can be detected by early CT angiography of the circle of Willis. The effects on brain perfusion can also be demonstrated by CT perfusion studies and the common carotid bifurcations assessed for atheromatous plaque and luminal narrowing; being a common source for such emboli.
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