File:Acute right MCA infarct, meningioma and retinal detachment (CT perfusion) (Radiopaedia 42428-45547 Axial CTA 224).png

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Acute_right_MCA_infarct,_meningioma_and_retinal_detachment_(CT_perfusion)_(Radiopaedia_42428-45547_Axial_CTA_224).png ‎(512 × 512 pixels, file size: 101 KB, MIME type: image/png)

Summary:

Description
  • Radiopaedia case ID: 42428
  • Image ID: 18999723
  • Image stack position: 224/399
  • Plane projection: Axial
  • Aux modality: CTA
  • Modality: CT
  • System: Central Nervous System
  • Findings: CT brain Right frontal lobe encephalomalacia with confluent white matter hypoattenuation involving the right frontal and right parietal lobe unchanged from the prior study 6 moths earlier consistent with an old right MCA infarct. Hyperdense right MCA consistent with acute thrombus. Hyperattenuating extra axial mass arising from the right sphenoid ridge measuring 2.5cm. Atrophic changes with prominence of the cortical sulci and ventricular system. Brainstem and cerebellum are within normal limits. No acute intraparenchymal hemorrhage. Unchanged hypoattenuation within the right lobe most consistent with retinal detachment with hemorrhage. CTA Calcification of the aortic arch. Origin of the innominate artery is not identified. The common carotids, internal carotids, vertebral and basilar arteries are patent. Calcified atheroma of the right and left carotid bulb with no haemodynamically significant stenosis. Tortuosity of the right internal carotid artery. Bilateral carotid siphon calcification. Normal circle of Willis anatomy. Occlusive thrombus within the proximal right MCA (M1). Normal contrast opacification of the anterior cerebral, posterior cerebral and left middle cerebral arteries. CT perfusion Perfusion imaging is confounded by the presence of the previous right MCA infarct. Reduced CBF within the right frontal lobe consistent with a region of established chronic infarct present on the non-contrast CT. MTT and Tmax are increased within the entire right MCA territory consistent with proximal occlusive thrombus, although the volume of the acute perfusion deficit is difficult to establish given the prior right MCA infarct. Conclusion
Date Published: 18th Sep 2016
Source https://radiopaedia.org/cases/acute-right-mca-infarct-meningioma-and-retinal-detachment-ct-perfusion
Author Craig Hacking
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

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Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)

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