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[Hyperdense middle cerebral artery sign among patients with severe ischemic attack on ultra-early phase]

Hong-song Song1, Hui-shu Yuan, Dong-sheng Fan

  • 1Department of Neurology, Peking University Third Hospital, Beijing 100191, China.

Beijing Da Xue Xue Bao. Yi Xue Ban = Journal of Peking University. Health Sciences
|February 23, 2012
PubMed

Insights

The hyperdense middle cerebral artery sign (HMCAS) appears in 23.3% of severe ischemic stroke patients. HMCAS indicates larger middle cerebral artery territory infarction and worse early neurological decline.

Area of Science:

  • Neurology
  • Radiology
  • Emergency Medicine

Background:

  • Stroke is a leading cause of death and disability worldwide.
  • Early detection of ischemic stroke is crucial for timely intervention.
  • The hyperdense middle cerebral artery sign (HMCAS) on non-enhanced CT may indicate early ischemic changes.

Purpose of the Study:

  • To determine the frequency of HMCAS in patients with severe middle cerebral artery (MCA) territory ischemic stroke.
  • To compare baseline characteristics and 90-day outcomes between HMCAS-positive and HMCAS-negative patients.

Main Methods:

  • Retrospective analysis of 43 patients with severe MCA ischemic stroke (NIHSS ≥ 10) within 3 hours of onset.
  • Evaluation included clinical data, laboratory tests, and brain CT/MRI.
  • Ninety-day follow-up assessed modified Rankin Scale (mRS), Bathel Index (BI), and mortality.

Main Results:

  • HMCAS was detected in 10 out of 43 patients (23.3%).
  • HMCAS-positive patients showed significantly higher 24-hour NIHSS scores (20.2 vs. 14.8, P=0.037).
  • All HMCAS-positive patients had larger MCA territory infarction (100% vs. 39.1%, P=0.001) compared to HMCAS-negative patients.

Conclusions:

  • HMCAS is a significant indicator of severe MCA infarction.
  • HMCAS-positive patients experience notable early neurological deterioration.
  • HMCAS on admission CT is an alarming sign in severe MCA territory ischemic stroke, warranting close monitoring.
Abstract

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