Evolving Infarction in the Anterior Circulation: CT Imaging Clues Every Clinician Must Recognize Before It's Too Late
Introduction: A Headache That Changed Everything A 48-year-old woman with a history of migraine arrived at the emergency department complaining of a sudden, severe headache and mild weakness of her left arm. At first glance, the symptoms seemed relatively benign. However, within hours, she deteriorated dramatically and developed complete left-sided paralysis. Brain CT imaging revealed one of the most feared neurological emergencies: a rapidly evolving infarction involving the anterior cerebral circulation. This clinical scenario illustrates a critical lesson in modern emergency diagnosis. In acute ischemic stroke, time is not merely money—it is brain tissue. Today, advances in medical imaging, CT scan diagnosis, and radiology interpretation allow physicians to identify subtle signs of cerebral infarction before irreversible damage occurs. Yet many early findings remain underrecognized. This article explores the pathophysiology, epidemiology, clinical presentation, imaging features, dif...