case_images: PMC4992528_01
case_images: Text message sent at the time of stroke (autocorrection: on).
case_images: CRINM2016-3406038.001.jpg
case_images: PMC4992528_01_CRINM2016-3406038.001.jpg
case_images: fig1
case_images: She sent her mother a text message at 0614 which read as follows: "Would you can won't write wouldn't write for a while long time and couldn't drive right it's something is wrong is and if I don't use the right don't use the right use right really a lot of right thing I can't think." (Figure 1) Due to the inability to talk and text coherently, she was brought into the ED.
case_images: MRI brain: area of diffusion restriction in the left insula.
case_images: CRINM2016-3406038.002.jpg
case_images: PMC4992528_01_CRINM2016-3406038.002.jpg
case_images: fig2
case_images: Magnetic Resonance Imaging (MRI) scan of the brain showed diffusion restriction in the left insula and parietal cortex suggestive of acute/subacute ischemic stroke (Figure 2).
case_images: MRA: diminished flow in anterior division of left middle cerebral artery.
case_images: CRINM2016-3406038.003.jpg
case_images: PMC4992528_01_CRINM2016-3406038.003.jpg
case_images: fig3
case_images: Magnetic Resonance Angiography (MRA) revealed occlusion of distal left middle cerebral artery branch with possible stenosis in the left posterior cerebral artery (Figure 3). Medication history revealed recent use of oral contraceptive pills (OCPs) containing combination estrogen/progesterone which were started in the preceding month.