Findings
Non-contrast head CT shows a left MCA stroke with a hyper dense linear structure in the left MCA. Angiogram confirms suspicion of thrombus in the left MCA.
Diagnosis: Acute left MCA stroke with thrombus seen on CT-angiogram
Key points
On MRI: Diffusion restriction with correlation on ADC map is diagnostic.
Seen as a hypo attenuating lesion on non-contrast Head CT.
Head CT can have false negative for acute stroke.
The hyperdense MCA sign implies acute thrombus and is a poor prognostic indicator.
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