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The hypodense artery sign.

Thomas C Lee1, Eric S Bartlett, Allan J Fox

  • 1Division of Neuroradiology, Department of Medical Imaging, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

AJNR. American Journal of Neuroradiology
|September 13, 2005
PubMed
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An unusual case of acute stroke showed a hypodense artery on CT, not the typical hyperdense sign. This fat density embolus in the middle cerebral artery highlights a rare cause of acute intracranial events.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Imaging

Background:

  • Acute intracranial emboli typically present as a hyperdense artery sign on computed tomography (CT) due to acute thrombus.
  • This sign is a well-established indicator of acute ischemic stroke.

Observation:

  • We report a rare case of acute middle cerebral artery (MCA) territory infarct.
  • The affected MCA segment appeared hypodense on initial CT imaging.

Findings:

  • The hypodense lesion demonstrated Hounsfield unit attenuation consistent with fat density.
  • CT angiography and magnetic resonance (MR) imaging confirmed the presence of a fatty embolus within the MCA.

Implications:

  • This case expands the imaging spectrum of intracranial emboli.

Related Experiment Videos

  • Fat emboli, though rare, should be considered in the differential diagnosis of acute stroke with atypical CT findings.
  • Advanced imaging is crucial for characterizing unusual embolic material.