Stroke, Ischemic

As the saying goes: "time is brain."



This patient presented with right hemiparesis and aphasia. A CTA revealed a left M2 occlusion. What this image shows is how collaterals came to the rescue. The patient subsequently underwent a successful mechanical thrombectomy with TICI 2C reperfusion.


This patient underwent DSA for the treatment of intracranial vasospasm.

(A): Posterior circulation run showed collateral flow to an ACA branch (red arrow).
(B): Left ICA injection showed severe left A1 (orange arrow) vasospasm, explaining the presentation seen in (A).
(C): This same ACA branch (red arrow) could be faintly seen on the lateral run of the left ICA injection.


This patient presented with left hemiparesis and a stroke alert was activated. CTA head and neck showed an aortic dissection, complete occlusion of the brachiocephalic artery origin, and partial occlusion of the left CCA origin.