Hyper dense artery sign is an extremely valuable marker of middle cerebral artery occlusion on computed tomography in patients with early hemiparesis

Sultan Abdulwadoud Alshoabi; Kamal Dahhan Alsultan

doi:10.5455/ajdi.20190824024709

Abstract
Hyperdense artery sign (HAS) is the earliest sign of cerebral infarction on non-enhanced computed tomography (NECT). HAS can be visible before irreversible cerebral damage. A 70 years old woman presented to the emergency room with left sided weakness and facial drooping since five hours. Head NECT showed HAS in the proximal part (M1) of the right middle cerebral artery (MCA). After 65 hours, follow up, NECT revealed large hypodense area in territory of the right MCA with mass effect in the form of compression of the ipsilateral lateral ventricle. This was a case of right MCA infarction. On follow up, the patient was not improved and discharged with right sided hemiplegia. HAS is a highly valuable marker for diagnosis of early cerebral infarction in patients with acute hemiparesis. The patients of hemiparesis with HAS should be dealing rapidly as acute ischemic stroke.

Key words: Cerebral artery occlusion, computed tomography, hemiparesis, hyperdense artery sign, valuable marker