open access
Hyperdense middle cerebral artery sign as the only radiological manifestation of hyperacute ischemic stroke in computed tomography
- Katedra Radiologii, Uniwersytet Jagielloński Collegium Medicum, Kraków, Poland
open access
Abstract
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.
MethodsThe 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.
ResultsThe 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).
ConclusionIn 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.
Abstract
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.
MethodsThe 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.
ResultsThe 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).
ConclusionIn 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.
Keywords
Hyperacute cerebral ischemic stroke, Hyperdense middle cerebral artery sign, Alberta Stroke Program Early Computed Tomography Score, Computed tomography
Title
Hyperdense middle cerebral artery sign as the only radiological manifestation of hyperacute ischemic stroke in computed tomography
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
33-37
Page views
236
Article views/downloads
758
DOI
10.1016/j.pjnns.2016.10.003
Bibliographic record
Neurol Neurochir Pol 2017;51(1):33-37.
Keywords
Hyperacute cerebral ischemic stroke
Hyperdense middle cerebral artery sign
Alberta Stroke Program Early Computed Tomography Score
Computed tomography
Authors
Robert Chrzan
Agnieszka Gleń
Andrzej Urbanik