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Thrombus localization with emergency cerebral CT.

T Tomsick1, T Brott, W Barsan

  • 1Department of Radiology, University of Cincinnati, OH 45267-0742.

AJNR. American Journal of Neuroradiology
|January 1, 1992
PubMed
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The hyperdense middle cerebral artery sign (HMCAS) on CT scans accurately predicts middle cerebral artery occlusion in acute stroke patients. This sign is associated with larger infarct volumes following treatment.

Area of Science:

  • Neuroradiology
  • Acute Stroke Imaging
  • Cerebrovascular Diseases

Background:

  • The hyperdense middle cerebral artery sign (HMCAS) is a potential early indicator of ischemic stroke.
  • Early detection of middle cerebral artery (MCA) occlusion is crucial for timely treatment.

Purpose of the Study:

  • To determine the prevalence of HMCAS in acute ischemic stroke patients treated with intravenous tissue plasminogen activator (tPA).
  • To correlate HMCAS with arteriographic findings and subsequent infarct volume.

Main Methods:

  • 55 acute ischemic stroke patients underwent CT scans before tPA treatment.
  • A neuroradiologist, blinded to other data, identified HMCAS on CT scans.

Main Results:

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  • HMCAS was detected in 34.5% of patients (19/55).
  • Arteriography confirmed MCA occlusion in 12 of 14 true positive cases.
  • Patients with HMCAS developed significantly larger infarcts (132 cc vs. 52 cc).

    • Conclusions:

    • HMCAS on CT is a reliable predictor of MCA occlusion.
    • The presence of HMCAS indicates a higher risk of developing a large infarct.