MCA host to amost 2/3s of all infarcts
Noncontrast head CT - radiologic exam of choice
rules out hemorrhage
may define patterns/extent of ischemia
demonstrates abnormal vascular calcifications
CT scans done within 6 hours - 1. Hyperdense Artery Sign - embolism 2. "insular ribbon sign" - blurring of the gray-white matter differentiation caused by early edema.
6-12 hours - Sulcal effacement +/- Decreased attenuation
12-24 hours - decreased attenuation
3-7 days - Maximal swelling
3-21 days - Gyral enhancement
30-90 days - 1. Encephalomalacia 2. Loss of Enhancement
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