Presentation
Patient presented to the ER with left-sided weakness, tongue heaviness and decreased level of consciousness.
Patient Data
Partial blurring of the right lentiform and right caudate.
Hypodensity involving the right centrum semiovale along with some cortical loss above it. The hypodensity is approaching that of CSF density with no positive mass effect suggesting an old infarct.
Bilateral periventricular hypodensities mostly suggesting small vessel disease.
No shift of midline structures. No cerebellar tonsillar herniation. No intracranial hemorrhage is seen. Capacious CSF spaces.
Conclusion:
Acute right MCA stroke.
Case Discussion
Early CT findings of acute ischemic stroke include:
obscuration of lentiform/asymmetrical basal ganglia
loss of gray-white matter differentiation
These findings can be better perceived using stroke window, (40 WW 40 WC).
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