PMC5925102_01
Diffusion weighted imaging (DWI) sequence demonstrating restricted diffusion in the right MCA territory of the basal ganglia and temporal lobe.
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fig1
The patient was sent to MRI at that time which was suboptimal but showed diminished caliber of the right internal carotid artery (R ICA) and diminished flow through the right middle cerebral artery (R MCA) (Figure 1).
3D reconstruction of the CTA showing stenosis or embolus in the right MCA.
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fig2
He was intubated, CT angiogram was performed at approximately 6 hours after waxing and waning symptoms and showed an R MCA occlusion (Figures 2 and 3), and interventional radiology was contacted at this time.
3D reconstruction of the CTA showing poor filling and blood flow in the right MCA.
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fig3
He was intubated, CT angiogram was performed at approximately 6 hours after waxing and waning symptoms and showed an R MCA occlusion (Figures 2 and 3), and interventional radiology was contacted at this time.
Postthrombectomy, CTA maximum intensity projection (MIP) shows improved blood flow and distal filling of the right MCA.
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fig4
Interventional neuroradiology was able to perform a mechanical thrombectomy of the R ICA and R MCA with successful clot retrieval (Figure 4).