Correlation of Early CT Signs in the Deep Middle Cerebral Artery Territories with Angiographically Confirmed Site of Arterial Occlusion
Shinichi Nakano
,a,
Tsutomu Isedaa,
Hirokazu Kawanoa,
Takumi Yoneyamaa,
Tokuro Ikedaa and
Shinichiro Wakisakaa
a From the Departments of Neurosurgery, Miyazaki Medical College (S.N., T.Is., S.W.) and Junwakai Memorial Hospital (H.K., T.Y., T.Ik.), Miyazaki, Japan.
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FIG 1. Representative early CT sign of grade I occlusion.
A, Nonenhanced CT scan in a 71-year-old man obtained 1.5 hours after left MCA stroke. Note loss of the left insular ribbon (arrows) versus normal right insular ribbon (arrowheads). The left lentiform nucleus appears normal.
B, Left carotid angiogram, obtained immediately after initial CT scanning, shows an embolic occlusion of the left M2 segment (arrow). Lateral lenticulostriate arteries (arrowheads) were well opacified from their origins.
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FIG 2. Representative early CT sign of grade III occlusion.
A, Nonenhanced CT scan in a 60-year-old woman obtained 2 hours after left MCA stroke. Note obscuration of the left entire lentiform nucleus (arrows).
B, Left carotid angiogram, obtained immediately after initial CT scanning, shows left MCA trunk occlusion at it origin (arrow). None of the lenticulostriate arteries were opacified.
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FIG 3. Representative early CT sign of grade II occlusion.
A, Nonenhanced CT scan in a 57-year-old woman obtained 3 hours after left MCA stroke. Note obscuration of posterolateral part of the left lentiform nucleus (arrow).
B, Left local angiogram, obtained using a microcatheter, shows left MCA trunk occlusion with partial opacification of the lenticulostriate arteries (arrows).
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