case_images: PMC6378419_01
case_images: CT without contrast of the brain completed upon presentation to the emergency department. Hyperdense right middle cerebral artery sign consistent with a right middle cerebral artery ischemic infarct.
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case_images: Immediate computed tomography (CT) imaging revealed a hyperdense right middle cerebral artery (MCA) sign ischemic infarct (Figure 1).
case_images: CT angiography of the brain completed during the administration of intravenous tissue plasminogen activator. Filling defect in the right distal middle cerebral artery (MCA) M1 segment. The superior division of the right MCA is not seen.
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case_images: Head CT angiography identified a filling defect in the right MCA M1 segment (Figure 2).
case_images: MRI without contrast of the brain completed approximately 5 h after the administration of intravenous tissue plasminogen activator. There is interval recanalization of the right distal most middle cerebral artery (MCA) M1 segment and of the superior division of the right MCA.
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case_images: On admission, further magnetic resonance imaging (MRI) without contrast approximately 5 h post-tPA showed interval recanalization of the right MCA M1 segment and no acute hemorrhage (Figure 3).
case_images: MRI including diffusion weighted imaging (DWI) of the brain completed approximately 5 h after the administration of intravenous tissue plasminogen activator. Only faint hyperintense DWI signal involving the right insula. No large territorial infarct.
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case_images: Diffusion weighted imaging (DWI) MRI showed only faint hyperintense DWI signal involving the right insula (Figure 4).