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MCA infarct (M1 occlusion)

Case contributed by Brendon Friesen
Diagnosis certain

Presentation

Left hemiparesis

Patient Data

Age: 85
Gender: Female
ct

No hemorrhage.

Hyperdense right MCA sign.

ct

Occlusion right M1 MCA.

ct

Incidental left frontal convexity meningioma.

ct

CT perfusion.

Right basal ganglia / external capsule critical hypoperfusion (core) [increased MTT, decreased CBF, decreased CBV].

Larger region of right MCA territory hypoperfusion (penumbra) [increased MTT, decreased CBF, normal CBV].

Case Discussion

Right MCA infarct with M1 MCA occlusion on CTA, hyperdense MCA sign on non-contrast CT, and features of infarction on CT perfusion imaging.

Critical hypoperfusion (core) = increased MTT, decreased CBF, decreased CBV].

Hypoperfusion (penumbra) = increased MTT, decreased CBF, normal CBV.

Incidental left frontal meningioma (presumed - not histologically proven).

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