Figure 1.

Demonstrative case showing cognitive improvement after TPA in patient with mild‐moderate baseline cognitive deficit. Eighty‐two years old R‐handed woman presents with sudden onset left sided hemiparesis and facial droop – received TPA with complete resolution of symptoms. MRI (Fig. 1A) showed few foci of restricted diffusion in right insula, temporal lobe, and corona‐radiata. Fazekas score of 4 (2 periventricular + 2 white matter). Patient determined to have moderate‐low cognitive baseline based on impact of covariates age, imaging, and YrE (16). Initial cognitive screening showed deficits on nine of nine tests. Three month follow‐up demonstrated improvement in all nine tests as well as normalization in four of nine tests (Fig. 1B).