Dense artery sign

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Obesity, Sleep & Internal medicine
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Dense artery sign
Synonyms	Hyperdense artery sign
Pronounce	N/A
Specialty	N/A
Symptoms	Sudden hemiparesis, aphasia, vision loss
Complications	Ischemic stroke, brain edema
Onset	Acute
Duration	Variable, depending on intervention
Types	N/A
Causes	Thromboembolism
Risks	Hypertension, atrial fibrillation, atherosclerosis
Diagnosis	CT scan
Differential diagnosis	Intracerebral hemorrhage, brain tumor
Prevention	N/A
Treatment	Thrombolysis, mechanical thrombectomy
Medication	N/A
Prognosis	Depends on time to treatment and severity
Frequency	Common in acute ischemic stroke
Deaths	N/A

Dense artery sign

The dense artery sign is a radiological finding observed on a non-contrast computed tomography (CT) scan of the brain. It is an important early indicator of an acute ischemic stroke, particularly involving the middle cerebral artery (MCA). This sign is characterized by the appearance of a hyperdense (bright) artery on the CT scan, which suggests the presence of a thrombus or clot within the vessel.

Pathophysiology

The dense artery sign occurs when a thrombus forms within a cerebral artery, most commonly the MCA. The thrombus is composed of blood components such as fibrin and platelets, which have a higher density than the surrounding brain tissue and blood. This increased density is what makes the artery appear hyperdense on a CT scan. The presence of a thrombus leads to reduced or completely obstructed blood flow to the brain tissue supplied by the affected artery, resulting in ischemia and potential infarction.

Clinical significance

The identification of the dense artery sign is crucial for the early diagnosis and management of acute ischemic stroke. Early detection allows for timely intervention, such as the administration of thrombolytic therapy or mechanical thrombectomy, which can significantly improve patient outcomes. The dense artery sign is often one of the first radiological signs of an ischemic stroke, appearing before other changes such as brain tissue hypodensity or swelling.

Imaging characteristics

On a non-contrast CT scan, the dense artery sign is seen as a hyperdense line or dot corresponding to the course of the affected artery. In the case of the MCA, this may appear as a hyperdense line in the sylvian fissure. The sign is more easily detected in the early stages of a stroke, before significant brain edema or other changes obscure the view.

Differential diagnosis

While the dense artery sign is a strong indicator of an acute ischemic stroke, it is important to consider other potential causes of hyperdensity on a CT scan. These can include calcified arteries, which are more common in older patients, or other forms of vascular calcification. Clinical correlation and further imaging, such as magnetic resonance imaging (MRI) or CT angiography, may be necessary to confirm the diagnosis.

See Also

• Stroke
• Ischemic stroke
• Middle cerebral artery
• Thrombolysis
• Computed tomography