Dense Artery Sign

Abstract

a 52-year-old gentleman with hypertension and diabetes mellitus for long time, presented with sudden onset of inability to talk and move the right side of the body. There was no preceding headache, fever, trauma, or any known provocating factors. Physical examination had shown raised blood pressure, pulse 92 beats per minute, motor aphasia, and dense right hemiplegia with upper motor neuron signs. A non-enhanced CT-scan of brain, done within thirty minutes of onset of illness, had shown no established features of ischemic or haemorrhagic insult to the brain, but an increased density of the left middle cerebral artery (Fig.1).Ischemic stroke was suspected from this 'dense artery sign' in the CT. Diffusion weighted MRI of the brain confirmed an infarct in the left middle cerebral artery region (Fig.2). The patient was managed duly and discharged to home with further advice.Ischemic cerebral infarction cannot usually be diagnosed by computed tomography (CT) within the first 12-24 hours of the event. But increased density along the distribution of a major intracranial vessel (Dense Artery Sign), secondary to