44 year old male with acute onset speech difficulty. LSN 2 hours. NIHSS5
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mCTA: No proximal artery occlusion on single phase CTA.
Multiphase CTA: shows a patchy area of contrast hold-up involving the left frontal lobe (middle and inferior frontal gyri posteriorly). Retrospectively an M4 branch occlusion is identified.
Arch anatomy: Type 2 arch