Findings, case of Acute onset left arm weakness, gait difficulty, aphasia

Imaging Findings

Computed tomography of the head shows increased attenuation in the right middle cerebral artery (MCA), consistent with right MCA thrombosis (arrow). The right lentiform nucleus is obscured (arrow) and there is effacement of the sulci in the right hemisphere along the right MCA territory (arrow). These findings are consistent with acute right MCA thrombosis and right hemispheric infarction.

Magnetic resonance (MR) imaging and MR angiography of the brain were performed two days later to evaluate the cerebral vessels and exclude hemorrhagic infarction. MRI confirms a large territorial infarct in the right MCA distribution with mild mass effect on the right lateral ventricle (arrow). The MR angiogram demonstrates diminished caliber and signal intensity of the right MCA and its distal branches (arrow).

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