Hyperdense middle cerebral artery sign as the only radiological manifestation of hyperacute ischemic stroke in computed tomography.
OBJECTIVE
The main aim of the study was to find the effect of hyperdense middle cerebral artery sign (HMCAS), as the only admission computed tomography (CT) manifestation of ischemic stroke involving middle cerebral artery (MCA) region, on the extent of stroke measured by Alberta Stroke Program Early CT score (ASPECTS) in the follow-up CT. The secondary aim was to determine the correlation between length of hyperdense MCA segment on admission CT and ASPECTS in follow-up CT.


METHODS
The group analyzed consisted of 118 patients with ischemic MCA region stroke, with no early signs of brain tissue ischemia on admission CT, but infarcts confirmed in follow-up CT, with extent evaluated using ASPECTS. For the subgroups: 66 patients with HMCAS present and 52 with HMCAS absent, median ASPECTS values were compared. In the subgroup with HMCAS present, length of hyperdense segment was measured and correlation with ASPECTS was determined.


RESULTS
The median ASPECTS 6 (min. 0, max. 9) in the subgroup with HMCAS present was significantly lower, compared to the score 8.5 (min. 0, max. 9) in the subgroup with HMCAS absent. Moderate correlation between the length of hyperdense segment and ASPECTS was found (R=-0.45).


CONCLUSIONS
In patients with ischemic stroke involving MCA region and no early signs of brain tissue ischemia on the admission CT, HMCAS is associated with significantly lower ASPECTS in the follow-up CT. There is moderate correlation between the length of hyperdense MCA segment and ASPECTS.
Katedra Radiologii, Uniwersytet Jagielloński Collegium Medicum, Kraków, Poland. Electronic address: rchrzan@mp.pl.
Robert
R
Chrzan
Katedra Radiologii, Uniwersytet Jagielloński Collegium Medicum, Kraków, Poland.
Agnieszka
A
Gleń
Katedra Radiologii, Uniwersytet Jagielloński Collegium Medicum, Kraków, Poland.
Andrzej
A
Urbanik
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D020521:Stroke / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
Alberta Stroke Program Early Computed Tomography Score; Computed tomography; Hyperacute cerebral ischemic stroke; Hyperdense middle cerebral artery sign