title: [Hyperdense middle cerebral artery sign among patients with severe ischemic attack on ultra-early phase].
abstract: OBJECTIVE
  To detect the frequency of hyperdense middle cerebral artery sign (HMCAS) among patients with severe ischemic attack (baseline NIHSS score ≥ 10) in the middle cerebral artery (MCA) territory within 3 hours after onset and compare the baseline characteristics and 90-day outcomes between the HMCAS (+) and HMCAS (-) groups.
  
  
  METHODS
  A total of 43 patients were evaluated with baseline clinical characteristics, laboratory tests and brain CT/MRI. Follow-up evaluation at the end of 90 days included the modified Rankin Scale (mRS), the Bathel Index (BI) and death.
  
  
  RESULTS
  Ten out of forty-three (23.3%) patients were HMCAS (+).The 24-hour NIHSSS of HMCAS (+) group was significantly higher than that of HMCAS (-) group (20.2 ± 5.4 vs. 14.8 ± 7.2, P= 0.037). The follow-up scanning confirmed that all HMCAS (+) patients had larger MCA territory infarction and the ratio of large MCA territory infarction was significantly higher than that of HMCAS (-) group (100% vs. 39.1%, P = 0.001). There were no significant differences in age, gender, risk factors, time intervals, laboratory tests, 90-day functional outcomes between the two groups.
  
  
  CONCLUSIONS
  The HMCAS (+) patients had notable deterioration 24 hours after onset and had more severe MCA infarction. HMCAS detected by non-enhanced CT at admission should be considered as an alarming sign among patients with severe neurological deficit of MCA territory infarction.
authors.affiliation: Department of Neurology, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Hong-song
authors.initials: HS
authors.lastname: Song
authors.forename: Hui-shu
authors.initials: HS
authors.lastname: Yuan
authors.forename: Dong-sheng
authors.initials: DS
authors.lastname: Fan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents