Summary
The early CT finding of an hyperdensity of a portion of the middle cerebral artery Hyperdense Middle Cerebral Artery Sign (HMCAS), in patients with supratentorial stroke, is often indicative of an embolic occlusion. Aim of this study was to verify the incidence and reliability of the HMCAS and its possible correlation with early CT findings and with the extent of late brain damage. We studied 36 patients presenting with symptoms of stroke in the MCA territory, by means of CT and angiography performed respectively within 4 and 6 hours. Follow-up CT scans were then obtained after one week and three months from the ischemic event. The HMCAS was present in 50% of our patients and in this group it always correlated positively with the angiographic finding of occlusion. The same group presented a high incidence of erly CT hypodensity (88%). Finally the presence of HMCAS might be considered a negative prognostic sign for the development of extensive brain damage.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Olson TS, Skriver EB, Herning M (1985) Cause of cerebral infarction in the carotid territory. Its relation to the size and the location of the infarct and to the underlying vascular lesion. Stroke 16: 459–466
Bozzao L, Fantozzi LM, Bastianello S, Bozzao A, Argentino C, Lenzi GL, Fieschi C (1989) Ischaemic supratentorial stroke; angiographic findings in patients examined in the very early phase. J Neurol 236: 340–342
Mattle H, Grolimund P, Huber P, Sturzenegger M, Zurbrugg H (1988) Transcranial doppler sonographic findings in middle cerebral artery disease. Arch Neurol 45: 289–295
Yock DH jr (1981) CT demonstration of cerebral emboli. J Comput Assist Tomogr 5: 190–196
Gacs G, Fox AJ, Barnett HJM, Vinuela F (1983) CT visualization of intracranial arterial thromboembolism. Stroke 14: 756–762
Granstrom P (1986) CT visualization of thrombus in cerebral artery. Comput Assist Tomogr 10: 541–548
Matsumara A, Munekata K, Wickboldt J, Hori A (1987) Significance of thrombosed and patent vessels visualized by CT scan. A case report of middle cerebral artery thrombosis. J Med Imag 1: 11–14
Pressman BD, Tourje EJ, Thompson JR (1987) An early CT sign of ischemic infarction: increased density in a cerebral artery. AJNR 8: 645–648
Schuierer G, Huk W (1988) The unilateral hyperdense middle cerebral artery: an early CT-sign of embolism or thrombosis. Neuroradiology 30: 120–122
Tomsick TA, Brott TC, Olinger CP, Barsan W, Spilker J, Eberle R, Adams H (1989) Hyperdense middle cerebral artery: incidence and quantitative significance. Neuroradiology 31: 312–315
Tomsick TA, Brott TC, Chambers AA, Fox AJ, Gaskil MF, Lukin RR, Pleatman CW, Wiot JG, Bourekas E (1989) Hyperdense middle cerebral artery sign: limits of detectability. AJNR 10: 873
Lutman M (1989) Diagnosi precoce dell'infarto cerebrale. L'iperdensita' dell'arteria cerebrale media come primo segno TC di lesione ischemica. Radiol Med 77: 171–173
Zeumer H, Hacke W, Ringelstein EB (1983) Local intraarterial thrombolysis in vertebro-basilar thromboembolic disease. AJNR 4: 401–404
Bozzao L, Bastianello S, Fantozzi LM, Angeloni U, Argentino C, Fieschi C (1989) Correlation of angiographic and sequential CT findings in patients with evolving cerebral infarction. AJNR 10: 1215–1222
Bozzao L, Fantozzi LM, Bastianello S, Bozzao A, Fieschi C (1989) Early collateral blood supply and late parenchymal brain damage in patients with middle cerebral artery occlusion. Stroke 20: 735–740
Damasio H (1983) A computed tomography guide to the identification of cerebral vascular territories. Arch Neurol 40: 138–142
Saito I, Segawa H, Shiokawa Y, Taniguchi M, Tsutsumi K (1987) Middle cerebral artery occlusion: correlation of computed tomography and angiography with clinical outcome. Stroke 18: 863–868
Bozzao L, Angeloni U, Bastianello S, Fantozzi LM, Pierallini A, Fieschi C (1991) The value of early CT hypodensity in predicting MCA hemorrhagic infarction. Proceedings of the XIV Symposium Neuroradiologicum, London 17–23 June 1990. Springer, Berlin Heidelberg New York, pp 42–44
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bastianello, S., Pierallini, A., Colonnese, C. et al. Hyperdense middle cerebral artery CT sign. Neuroradiology 33, 207–211 (1991). https://doi.org/10.1007/BF00588219
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00588219