1. Teaching NeuroImages Neurology Resident and Fellow Section
A 38 YEAR OLD MAN WITH RIGHT SIDED WEAKNESS, SENSORYLOSS, & HEMIANOPSIA
Teaching NeuroImages Neurology Resident and Fellow Section
© 2014 American Academy of Neurology

2. VIGNETTE
A 38-year old man presented to the emergency department with right sided weakness, sensory loss and hemianopsia.
CT and CT Angiogram of the head were performed (Figures 1 and 2) .
Capampangan, et al.
© 2013 American Academy of Neurology

3. IMAGING Capampangan, et al.
Figure 1 – CT head showing a left hyperdense posterior cerebral artery sign (red arrows).
Capampangan, et al.
© 2014 American Academy of Neurology

4. IMAGING Capampangan, et al.
Figure 2 – CTA of the head demonstrating occlusion of the left posterior cerebral artery (red arrows).
Capampangan, et al.
© 2014 American Academy of Neurology

5. Hyperdense Posterior Cerebral Artery Sign
CT head showed a left hyperdense posterior cerebral artery sign (HPCAS) (Figure 1).
CT angiogram of the head confirmed a left PCA occlusion (Figure 2).
MRI demonstrated a left PCA infarct.
Transesophageal echocardiogram revealed an atrial septal aneurysm and patent foramen ovale.
He was treated with antiplatelet therapy.
The HPCAS has been considered a marker for acute ischemia in the PCA territory.
Recognizing the HPCAS on CT in acute stroke may help in the diagnosis and treatment of thromboembolic PCA branch occlusion.
References:
Krings T, Noelchen D, Mull M, Laus W, Meister IG, Reinacher P, Toepper R, Thron AK. The hyperense posterior cerebral artery sign: a computed tomography marker of acute ischemia in the posterior cerebral artery territory. Stroke 2006, 37:
Capampangan, et al.
© 2014 American Academy of Neurology