51 year old male presenting to the ED with right hemiparesis and aphasia. Imaging was initiated 4 hours after witnessed symptom onset. A &B. CTA demonstrates occlusion of the proximal left MCA (white arrows). C &D. Initial DWI shows large abnormality of the left MCA territory. E &F. MR perfusion time to peak (TTP) maps demonstrates hypoperfusion of similar extent as the diffusion abnormality. G &H. Follow-up MRI shows no significant enlargement of the initial abnormality. Whole brain map volume measurements for this patient are: DWI: 154 ml; MTT: 211 ml (mismatch: 57 ml); TTP: 241 ml (mismatch 87 ml).
Hakimelahi et al. BMC Neurology 2012 12:132 doi:10.1186/1471-2377-12-132