Document Detail

The hyperdense posterior cerebral artery sign: a computed tomography marker of acute ischemia in the posterior cerebral artery territory.
MedLine Citation:
PMID:  16397187     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: In the anterior circulation, the hyperdense middle cerebral artery (MCA) sign is a well-established marker for early ischemia. Similarly, the hyperdense basilar artery sign or the MCA "dot" sign may be a diagnostic clue for basilar artery or distal MCA branch thrombosis. The purpose of this study was to define the hyperdense posterior cerebral artery (PCA) sign and determine its incidence, diagnostic value, and reliability as a marker for ischemia in the territory of the PCA. METHODS: Cranial computed tomographies (CCTs) of 48 patients with proven acute ischemia (<12 hours) in the PCA territory were compared by 3 independent and blinded readers to the CCTs of 86 age-matched patients without PCA infarction. Using follow-up imaging, the correlation of the hyperdense PCA (HPCA) with infarct size, thalamic infarction, and bleeding were investigated. RESULTS: An HPCA was found in 35.4% of all patients with PCA infarction, typically within the ambient cistern, with a specificity of 95.4%. The thalamus was affected significantly more often (P=0.009) and the size of the infarct was significantly more often large than medium (P=0.018) or small (P<0.001) when an HPCA was present. Hemorrhagic transformation tended to occur more often when the HPCA was present. CONCLUSIONS: An HPCA was detected in more than one third of all patients with PCA ischemia, suiting the incidence of the hyperdense MCA. Based on our results, this sign may not only be helpful in the early diagnosis of PCA infarction but might also act as a prognostic marker in acute PCA territory ischemic stroke.
Timo Krings; Dagmar Noelchen; Michael Mull; Klaus Willmes; Ingo G Meister; Peter Reinacher; Rudolf Toepper; Armin K Thron
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Publication Detail:
Type:  Journal Article     Date:  2006-01-05
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  37     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-24     Completed Date:  2006-03-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  399-403     Citation Subset:  IM    
Department of Neuroradiology, RWTH Aachen University, Aachen, Germany.
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MeSH Terms
Aged, 80 and over
Brain / pathology
Brain Ischemia / diagnosis*,  pathology*
Case-Control Studies
Infarction, Posterior Cerebral Artery / diagnosis,  pathology
Middle Aged
Observer Variation
Posterior Cerebral Artery / pathology*,  radiography*
Retrospective Studies
Tomography, X-Ray Computed / methods*

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