A case of bilateral dense middle cerebral arteries with CT angiographic confirmation of vascular occlusion

Hyperattenuating middle cerebral arteries on CT in acute stroke should generally not be associated with presence of intraluminal clot when bilaterally seen. We report a case of a woman who underwent emergency CT 60 min after sudden onset of coma. Bilateral dense middle cerebral arteries without parenchymal hypoattenuating areas or indirect signs of cerebral edema were present. CT angiography confirmed occlusion of the right middle cerebral artery and left internal carotid artery and middle cerebral artery.