Sign, Hyperdense Artery

The hyperdense artery sign could be an early indication of an ischemic stroke secondary to an embolic occlusion of the corresponding artery.

Cases

1

This patient presented with an acute onset of left hemiparesis and altered mental status. A CT head without contrast showed a hyperdense basilar artery (yellow arrow in A and C), indicating embolic thrombus. This hyperdense sign was even more convincing since the patient had an old CT head (B and D) to compare with. Due to a contrast allergy, no CTA head was obtained at the OSH. The patient was subsequently intubated, and DSA confirmed the basilar occlusion (E and F). Mechanical thrombectomy yielded a TICI 2B reperfusion.