Extensive cerebral infarction

Case contributed by Islam Aly Abouzid
Diagnosis certain

Presentation

Sudden drop in GCS

Patient Data

Age: 80 years
Gender: Male

Initial CT brain

ct

Dense right middle cerebral artery sign. Early loss of grey-white matter differentiation in the right insular and surrounding regions.

Repeat CT brain 36 hours later

ct

Extensive acute infarction in the right middle cerebral artery territory with massive mass effect and edema causing subfalcine herniation. Further acute infarction in bilateral anterior cerebral artery territories, involving bilateral frontal gyri, presumably due to compression of both anterior cerebral arteries.

Case Discussion

Extensive MCA/ACA ischemic stroke with edema and mass effect. 

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