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Hyperintense MCA branch sign on FLAIR-MRI
Masatoshi Koga1, Kazumi Kimura, Kazuo Minematsu
1Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. mkoga@ff.iij4u.or.jp
Abstract:
We report three patients with cardioembolic stroke or transient ischaemic attack. Fluid-attenuated inversion recovery (FLAIR) MRI within hours of symptom onset, demonstrated linear hyperintensities on the surface of the cortex corresponding to neurologic deficits. This unusual finding was indicative of MCA branch occlusion that was confirmed or suggested with angiography. Ultra-early evaluation with FLAIR- and diffusion-MRI may help establish the diagnosis of acute ischaemic stroke particularly due to embolic MCA branch occlusion.
Insights
Early MRI scans can detect specific brain changes indicating a stroke caused by a blocked artery. This helps doctors quickly diagnose and treat acute ischemic stroke, especially from embolic middle cerebral artery branch occlusion.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Cardioembolic stroke and transient ischemic attacks (TIAs) are serious neurological events.
- Prompt diagnosis is crucial for effective treatment and improved patient outcomes.
- Identifying the cause, such as middle cerebral artery (MCA) branch occlusion, aids in targeted therapy.
Observation:
- Three patients with cardioembolic stroke or TIA were studied.
- Fluid-attenuated inversion recovery (FLAIR) Magnetic Resonance Imaging (MRI) was performed within hours of symptom onset.
- Linear hyperintensities on the cortical surface were observed, correlating with neurological deficits.
Findings:
- The observed cortical hyperintensities on FLAIR MRI were indicative of MCA branch occlusion.
- Angiography confirmed or suggested the presence of MCA branch occlusion.
- Ultra-early FLAIR and diffusion-weighted MRI (DWI) show potential for diagnosing acute ischemic stroke.
Implications:
- This imaging pattern may serve as an early diagnostic marker for specific stroke types.
- Ultra-early MRI evaluation can expedite the diagnosis of acute ischemic stroke.
- The findings highlight the utility of advanced MRI techniques in identifying embolic MCA branch occlusions.