Acute left MCA stroke with thrombus seen on CT-angiogram

Findings

Non-contrast head CT shows a left MCA stroke with a hyper dense linear structure in the left MCA. Angiogram confirms suspicion of thrombus in the left MCA.


Diagnosis: Acute left MCA stroke with thrombus seen on CT-angiogram


Key points

On MRI: Diffusion restriction with correlation on ADC map is diagnostic.
Seen as a hypo attenuating lesion on non-contrast Head CT.
Head CT can have false negative for acute stroke.
The hyperdense MCA sign implies acute thrombus and is a poor prognostic indicator.