The MCA dot sign is the cross-section equivalent of the hyperdense MCA sign. Rather than imaging a length of middle cerebral artery (typically the M1 segment), the dot sign represents a thromboembolus within a segmental branch of the MCA located within the Sylvian fissure. The sign appears when the high-attenuation MCA is viewed in cross section, since the occluded vessel courses in a plane perpendicular to the transverse plane of imaging.
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