Images in Clinical Medicine: Hyperdense MCA Sign
N Sethi, J Torgovnick, A Mohan, A Hirschfeld, B Zablow, I Omeis
N Sethi, J Torgovnick, A Mohan, A Hirschfeld, B Zablow, I Omeis. Images in Clinical Medicine: Hyperdense MCA Sign. The Internet Journal of Radiology. 2005 Volume 5 Number 1.
The 'hyperdense MCA sign' (HMCA) refers to the appearance, on computed tomography, of increased attenuation of the proximal portion of the middle cerebral artery (MCA) and is often associated with thrombosis of the M1 MCA segment. It is one of the early signs of ischemic stroke.
A 64-year old (R) handed female, with history of essential hypertension and type 2 diabetes mellitus, presented with 9-hour history of abrupt onset of right-sided weakness and difficulty speaking. Emergent head CT scan demonstrated a thrombus occluding the main stem of the left middle cerebral artery (
The HMCA sign also called as MCA “dot” sign is one of the early signs of ischemic stroke along with loss of the insular ribbon, attenuation of the lentiform nucleus and hemispherical sulcus effacement 1 .It may be the only diagnostic feature on computed tomography early after ischemic stroke. Various studies have been conducted to determine its incidence, diagnostic value, and reliability 2. False positives are recognized, and correct recognition of this sign has therefore, assumed greater importance especially with the advent of thrombolytic therapy for stroke 3.
Address for correspondence
Nitin Sethi, M.D. Chief Resident, Neurology Saint Vincent's Hospital and Medical Centers 153 West, 11th Street New York, NY 10011 Email: firstname.lastname@example.org