Hyperdense MCA sign
Hyperdense MCA sign : It can be seen with acute thrombus formation. A hyperdense MCA sign is indicative of an impending large infarct and is of very poor prognosis. This is a very early CT finding of impending infarction. It should be noted, however, that there are other causes of a hyperdense MCA such as atherosclerotic calcifications.
Other early findings in an acute stroke include loss of the insular ribbon as well as hypodensity within the lentiform nucleus. Loss of the gray/white junction is also an early finding in acute infarction.
The region of infarction can be more accurately located by magnetic resonance imaging. Such findings include absence of the normal “flow void” as well as edema with loss of the gray/white junction.
Computed tomograph after ischaemic stroke, showing hyperdense middle cerebral artery sign.
Reference : ISPUB l sBMJ l Anne G. Osborn, Diagnostic Neuroradiology 1994
