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Cerebellar Infarction Diagnosed by the 'Hyperdense Sign' on Plain CT
Shunsuke Nakamura1, Natsuyo Shinohara1, Shigeaki Inoue1
1Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, JPN.
Cureus
|July 16, 2025
Summary
A rare "dense vertebral artery sign" on CT scans helped diagnose vertebral artery dissection (VAD) in a young adult. This crucial imaging clue aids in prompt, life-saving treatment, especially when advanced imaging is unavailable.
Area of Science:
- Neurology
- Radiology
- Vascular Imaging
Background:
- Vertebral artery dissection (VAD) is a significant cause of stroke in young adults.
- Early diagnosis of VAD is critical for effective treatment and stroke prevention.
- Traditional diagnostic methods often rely on advanced imaging like MRI or CT angiography.
Observation:
- A young adult male presented with symptoms suggestive of VAD.
- Non-contrast computed tomography (CT) revealed an unusual finding: the "dense vertebral artery sign."
- This sign, a hyperdense appearance within the vertebral artery, was not initially recognized as definitive for VAD.
Findings:
- The "dense vertebral artery sign" on plain CT served as a pivotal clue for VAD.
- This subtle imaging finding led to the suspicion and subsequent confirmation of vertebral artery dissection.
- The case highlights the diagnostic utility of often-overlooked signs in non-contrast CT.
Implications:
- Subtle vascular signs on non-contrast CT can be crucial for diagnosing VAD.
- This diagnostic approach is particularly valuable in emergency settings lacking advanced imaging capabilities.
- Prompt identification of VAD through accessible imaging can lead to life-saving interventions and improved patient outcomes.
