Finding-the-Path: CT of the head

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.

What study do you request next?

• Cervical spine series
• Plain radiographs of the skull
• Brain MRI and MRA
• Cerebral angiogram
• Request no further imaging procedures