title: Hidden dense middle cerebral artery sign in a 4-year-old boy with traumatic subarachnoid hemorrhage.
abstract: A 4-year-old boy was admitted with acute onset of hemiplegia of the right side that was secondary to a traffic accident. Initial computed tomography revealed a traumatic subarachnoid hemorrhage, and follow-up computed tomography showed a more localized hematoma of the left sylvian cistern. After a few days of conservative treatment, magnetic resonance imaging (MRI) revealed a cerebral infarction of the left lenticulostriate territory, even though magnetic resonance angiography showed preserved middle cerebral artery flow. Thus, we realized that the hematoma of the sylvian cistern was the so-called dense middle cerebral artery sign. This case of posttraumatic infarction suggested the importance of meticulous investigations and clinical correlations of imaging studies in pediatric patients with head injuries.
authors.affiliation: Department of Neurosurgery, Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Bum-Joon
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Jong-Il
authors.initials: JI
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Sung-Kon
authors.initials: SK
authors.lastname: Ha
authors.affiliation: Department of Neurosurgery, Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Dong-Jun
authors.initials: DJ
authors.lastname: Lim
authors.affiliation: Department of Neurosurgery, Korea University Ansan Hospital, Ansan, Korea neuron19@korea.ac.kr.
authors.forename: Sang-Dae
authors.initials: SD
authors.lastname: Kim
mesh_terms: D000063:Accidents, Traffic; D002675:Child, Preschool; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D020768:Middle Cerebral Artery / Q000473:pathology*; D020206:Subarachnoid Hemorrhage, Traumatic / Q000473:pathology*; D015898:Tomography Scanners, X-Ray Computed
keywords: dense middle cerebral artery sign; lenticulostriate infarct; posttraumatic infarction; striatocapsular infarct; traumatic subarachnoid hemorrhage