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Fairly well circumscribed abnormal signals involving cortex and white matter are noted in left frontal lobe extending into left lentiform nucleus, in territory of left MCA.
One of the early CT findings in acute Middle Cerebral Artery (MCA) infarction is that of obscuration of lentiform nucleus, which is due to cellular oedema in the basal ganglia.
The lesion involved the posterior aspect of the left lentiform nucleus, the posterior aspect of left internal capsule, the insula, and the external capsule.
Figure-3: Subtle increased signal in bilateral caudate and lentiform nucleus (green arrow) and subcortical ribboning (red arrow) on DWI.
Signs of acute infarction include obscuration of normal brain structures, such as the insular ribbon (2) and lentiform nucleus, (3) hyperdense artery, (4) or in less acute cases, parenchymal hypodensity and mass effect (Figure 1).