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[Dense middle cerebral artery: etiologic significance and prognosis]
Abstract:
Five cases of infarction in the territory of the middle cerebral artery (MCA) are reported. The main feature common to these 5 cases was the presence at CT without contrast injection, in the first 24 hours, of a spontaneous hyperdensity of the ipsilateral MCA. In one case, angiography demonstrated that this hyperdensity was associated with occlusion. In 2 other cases, doppler examination showed occlusion of the internal carotid artery. The transient character of these radiological findings is underlined. In the acute phase of an infarction, hyperdensity of the MCA at an early CT scan without contrast injection suggests an occlusive mechanism and massive infarction with poor clinical outcome.
Insights
Early CT scans showing a dense middle cerebral artery (MCA) indicate artery occlusion and severe stroke. This finding in the first 24 hours suggests a poor prognosis for stroke patients.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Middle cerebral artery (MCA) infarction is a common cause of stroke.
- Early detection of MCA infarction is crucial for timely intervention and improved patient outcomes.
- Computed tomography (CT) without contrast is a primary imaging modality for acute stroke assessment.
Observation:
- Five cases of MCA infarction were analyzed.
- A consistent finding across all cases was spontaneous hyperdensity of the ipsilateral MCA on early CT scans (within 24 hours) without contrast.
- This hyperdensity was transient in nature.
Findings:
- Angiography confirmed MCA occlusion in one case.
- Doppler examination revealed internal carotid artery occlusion in two cases.
- Early MCA hyperdensity on non-contrast CT is a significant indicator of an occlusive mechanism.
Implications:
- Spontaneous MCA hyperdensity on early CT suggests a high likelihood of massive infarction.
- This radiological sign is associated with a poor clinical outcome.
- The findings highlight the importance of recognizing early CT signs for predicting stroke severity and guiding treatment strategies.