44 year old male with acute onset speech difficulty. LSN 2 hours. NIHSS5
ASPECTS: 10
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.
Collaterals: Good
Arch anatomy: Type 2 arch
CT perfusion: Small area of potential infarct- on TMax map in left inferior frontal gyrus
3] Decision making: IV tPA- Yes
4] 24 hr MRI- Small infract in the left MCA territory, no hemorrhage
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