Axial CT image (narrow window) shows a hyperdense left MCA, representing an intraluminal thrombus.
Hyperdense MCA Sign
- Visualization of high density middle cerebral artery due to presence of intraluminal thrombus
- Specific sign for thrombotic MCA occlusion, but it is not sensitive
- Associated with poor prognosis and higher risk of hemorrhage if thrombolyzed
- Early resolution indicates successful reperfusion and favorable outcome after thrombolysis
- Intraluminal thrombus
- High hematocrit (usually bilateral)
- Calcified plaque (usually bilateral)
Rabinstein AA, Resnick SJ. Practical Imaging in Stroke: a Case-based Approach, 2009.