Case 2. 84 yo female with acute onset of L hemiparesis and L facial droop. Presents to ED 16 hrs after onset of symptoms. PE: awake, unable to follow commands, L sided neglect, L facial droop, 0/5 strength in LUE + LLE, upgoing Babinski on L. Non-Contrast Head CT.
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In the M1 segment, thrombus runs parallel to plane of axial CT images, creating the hyperdense MCA sign.
In M2 and M3 segments, thrombus runs perpendicular to plane of axial CT images, creating the dot sign.
Image from: Leary MC et al. Stroke 34 (11) 2636-2640.
(on the insula)
Image from: Neafsey E. www.meddean.luc.edu
2-5 can be considered potential “false positives”
- Sensitivity: 35-40%
- Specificity: 95-100%