Skip to main content
. 2014 Apr 2;34(6):1076–1081. doi: 10.1038/jcbfm.2014.57

Figure 1.

Figure 1

Successful treatment. A 70-year-old man with hypertension, diabetes, hyperlipidemia, and paroxysmal atrial fibrillation presented with sudden left-sided hemiparalysis, head and eye deviation to the right and neglect. National Institutes of Health Stroke Scale (NIHSS) was 17. He was not on anticoagulation. Magnetic resonance imaging (MRI) performed 2 hours and 36 minutes after symptom onset revealed a small infarct in the basal ganglia, depicted by restricted diffusion on the apparent diffusion coefficient (ADC) image (A). T2*-weighted imaging (B) showed a clot in the stem of the right middle cerebral artery (MCA). Marked hypoperfusion of the entire MCA territory was evident on the mean transit time (MTT) image (C). The patient was given intraveneous tissue plasminogen activator (tPA) and taken to intraarterial therapy (IAT) immediately without waiting for effect. The right MCA was still occluded on the first run of the digital subtraction angiography (DSA) (D). The clot was successfully removed (E). After thrombectomy, DSA showed the right MCA was now open (F). Recanalization was achieved 5 hours and 18 minutes after symptom onset. At the 24-hour follow-up MRI, the infarct had not grown, but was still in the basal ganglia (G). NIHSS the day after was 7.