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New research · Cardiology
Radiology case reports · 4d
Case reportRadiology case reports · 2026

Malignant middle cerebral artery infarction revealing atrial fibrillation: A Multimodal imaging case of M1 occlusion treated with decompressive craniectomy.

Hafsa Erregui, Mehdi Moujahid, Hamza Madouim … Nawfal Doghmi
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CardiologyCase report

Severe brain swelling caused a significant midline shift in malignant stroke.

Malignant middle cerebral artery infarction revealing atrial fibrillation: A Multimodal imaging case of M1 occlusion treated with decompressive craniectomy.

Hafsa Erregui et al. · Radiology case reports · 2026
Background

Malignant middle cerebral artery (MCA) infarction represents a severe form of ischemic stroke characterized by extensive cerebral ischemia, rapid development of cerebral edema, and a high risk of fatal brain herniation.

12
Results
mm
the brain's center was pushed sideways due to severe swelling
n = 1 case
More results

We report the case of a 70-year-old woman with poorly controlled hypertension who presented with acute left-sided hemiplegia and altered consciousness with a delay of approximately 48 hours from symptom onset.

Electrocardiography revealed previously undiagnosed atrial fibrillation with rapid ventricular response.

More results

Multimodal magnetic resonance imaging confirmed a large cortico-subcortical infarction involving more than 50% of the right MCA territory, with marked diffusion restriction and no diffusion-FLAIR mismatch, indicating a completed infarction.

MR angiography demonstrated occlusion of the M1 segment of the right MCA.

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Conclusion

Early detection and appropriate anticoagulation of atrial fibrillation remain essential to prevent severe cardioembolic stroke.

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