Hyperdense MCA Sign

Abstract

She underwent uneventful coronary artery bypass grafting with 3 appropriate grafts. Early postoperative course was uneventful, started on antiplatelets, anticoagulants, statins, and supportive care and shifted out of ICU on POD2. On 5 th postoperative day, she developed sudden onset right hemiparesis, deviation of mouth to left and drowsiness. On physical examination, patient had profound right-sided neglect and conjugate deviation of the eyes to the left side. Motor examination showed grade 0 power on right upper and lower extremities, 3+ reflexes on the right and 2+ reflexes on the left with positive babinski on the right side. She was intubated, shifted to emergency CT brain to rule out acute cerebro vascular accident. CT showed a linear hyperdense structure extending from left ICA bifurcation into left sylvian fissure, suggestive of hyperdense left MCA (HU 69) could be secondary to acute thrombus. Rest of brain in and territory of with