Figure 2.

A 29-year-old female with rheumatic heart disease and chronic atrial fibrillation developed facial drooping and acute hemiparesis 24 h after redo mitral valve replacement. Computed tomography of the brain and angiography revealed acute large right middle cerebral artery (MCA) territory ischemic insult, large vessel occlusion involving the M1 segment of the right MCA, and impaired perfusion parameters (A1–5). Cerebral angiography showed total occlusion of M1 branch of the right MCA (B1). Image B2 shows the thrombolysis in cerebral infarction Flow III after thrombus aspiration, with areas of narrowing consistent with nonflow limiting vasospasm. The patient was discharged without any residual weakness.