History: 37 year old female, stroke code, left-sided weakness.
Pertinent findings:
Dense MCA sign: Hyperdensity within the right MCA, extending into the superior M2 division.
Impression:
1. Findings consistent with right superior MCA territory infarction.
2. Dense vessel sign consistent with large vessel occlusion of the superior division of the right M2 branch.
Further imaging:
The patient went on to undergo
CTA of the head and neck, and stroke protocol
MRI, which confirmed the above findings, with acute thrombotic occlusion of the superior M2 division of the right MCA, corresponding
perfusion abnormality, and acute infarction throughout that territory in the distribution described above.
Further reading:
State-of-the-Art Imaging of Acute Stroke. RadioGraphics 2006: http://pubs.rsna.org/doi/10.1148/rg.26si065501
CT Protocol for Acute Stroke: Tips and Tricks for General Radiologists. RadioGraphics 2008: http://pubs.rsna.org/doi/10.1148/rg.286085502