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The following is a summary of “Prognostic significance of hyperdense middle cerebral artery sign in cardioembolic stroke patients undergoing mechanical thrombectomy,” published in the February 2025 issue of BMC Neurology by Liu et al. 

Researchers conducted a retrospective study to assess the association between hyperdense middle cerebral artery sign (HMCAS) on CT before Mechanical thrombectomy (MT) and poor functional outcomes or Symptomatic hemorrhagic transformation (sHT) in patients suffering from large vessel occlusion (LVO) with Cardioembolism (CE) and large artery atherosclerosis (LAA) etiology. 

They conducted a retrospective analysis using patient data from 3 comprehensive stroke centers. Patients were categorized into 4 groups: LAA with HMCAS, LAA with no HMCAS, cardioembolic with HMCAS, and cardioembolic with no HMCAS. They compared the 90-day Modified Rankin score (mRS) and sHT incidence between groups 1 vs 2 and 3 vs 4. 

The results showed that among 295 patients, 93 (31.5%) had HMCAS. Patients with HMCAS and CE had a poorer outcome, with no significant difference in sHT rates between groups 3 and 4. Multivariate analysis confirmed HMCAS as an independent predictor of poor prognosis in patients with CE undergoing MT (OR: 0.193, 95% CI: 0.040–0.937, P = 0.041). 

Investigators found that in patients suffering from acute ischemic stroke-large vessel occlusion (AIS-LVO) with cardioembolic etiology undergoing MT, HMCAS on initial pre-treatment non-contrast CT (NCCT) was associated with an unfavorable outcome. 

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-025-04073-z