Division of Neuroradiology, Massachusetts General Hospital, Boston 02114, USA. mmullins@partners.org
The hyperdense artery sign on noncontrast head CT is thought to be one of the earliest and most useful signs of intra-arterial clot and probable (clinical) stroke. It should be evaluated in the context of the clinical scenario. Rigorous criteria should be applied in order to reduce potential false positives. The hyperdense middle cerebral artery sign is the most studied version and correlates with patient outcome. Our data suggest that the density on noncontrast head CT is not likely to universally represent in situ clot.