Carrillo ER, Garcilazo RYJ, Lee CD, Peralta PAB, González NP, Rodríguez OU

Language: Spanish
References: 25
Page: 384-388
PDF size: 113.86 Kb.

ABSTRACT

The hyperdense middle cerebral artery sign (HMCAS) is an indirect sign of cerebral ischemia that correlates with occlusion of the middle cerebral artery. It is recognized as an area of increased attenuation when it is compared to the contralateral side along the first or second segments of the stem of the middle cerebral artery. HMCAS is a marker of risk for the development of a large cerebral infarct and a determinant for receiving thrombolytic therapy.
44 year old, right-handed man suffering aphasia and weakness of the right side of the face, he presented with aphasia and right-sided central facial paresia. The non-contrast cerebral CT at the time of admission showed hyperdensity of the left middle cerebral artery, with 56 HU. The diagnosis of acute ischemic stroke was made and the patient was treated with intravenous thrombolysis. After the infusion with tissue plasminogen activator, clinically significant improvement and a decrease in the density of the left middle cerebral artery in the control CT was observed.
HMCAS is a sensitive, accurate and prognostic marker of middle cerebral artery thromboembolism, but it should be used cautiously when taking decisions since it may not always represent vascular occlusion. The identification of HCMCAS is extremely valuable in the early diagnosis of cerebral infarction and in instituting an appropriate therapeutic regimen.

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