Presentation
Aphasia, dysarthria, and facial palsy for 4 hours. Stroke alert.
Patient Data
Restricted diffusion in the cortex of the left frontal, parietal, and temporal region with a corresponding mild flair hyperintensity in the left frontal cortex.
Occlusion of the left middle cerebral artery at the M1-M2 junction on MRA with loss of flow void on Flair images and a thrombus on gradient echo images
No intracranial bleeding.
Abnormal flow and vessel contours involving the C2 segment of the left internal carotid artery on MRA.
Left-sided T1 hyperintensity adjacent to the lumen of the internal carotid artery (C1 and C2), suggestive of a mural hematoma.
No brain herniation or mass effect. The ventricular system is unremarkable.
Case Discussion
Medical treatment was not an option for this young patient and he was referred for angioplasty and stent placement.
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