Cerebellar Infarction Diagnosed by the 'Hyperdense Sign' on Plain CT

TL;DR

A rare case of a cerebellar infarction was diagnosed using a 'dense vertebral artery sign' on a standard CT scan, highlighting its importance in emergency settings.

Contribution

Demonstrates the diagnostic utility of the 'dense vertebral artery sign' on plain CT for detecting vertebral artery dissection in emergency scenarios.

Findings

The 'dense vertebral artery sign' on non-contrast CT indicated a possible vertebral artery dissection.

Early detection via this sign led to prompt intervention in a young patient.

Plain CT can reveal critical vascular signs when advanced imaging is unavailable.

Abstract

We hereby present a case of thrombus or possible vertebral artery dissection (VAD), but no confirmatory evidence in a young adult male, diagnosed using an unusual but pivotal imaging clue, the "dense vertebral artery sign" observed on non-contrast computed tomography (CT). This finding led to the initial suspicion and subsequent confirmation of VAD. This report underscores the diagnostic value of subtle vascular signs on plain CT imaging that are frequently overlooked but can result in prompt and life-saving intervention. This report is of particular significance in emergency settings, where advanced imaging modalities such as MRI and CT angiography may not be readily available.

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