Fig. 8

A 41-year-old obese, normotensive female treated with hormonal contraception developed left-sided hemiplegia at 6 a.m. a Acute CT at 7:30 a.m. shows a mild hyperdense lesion in the distribution of the right MCA and a large perfusion deficit with no penumbra on b CBF and c CBV maps. At 8:20 a.m. intravenous Actilyse was applied, and at 10:35 a.m., despite the absence of penumbra, d mechanical thrombolysis of the obliterated right MCA was performed e with successful thrombus removal. Left-sided hemiplegia resolved within a week. Six weeks after the stroke the patient was fully independent, going to work, driving a car and feeling no limitation of her left extremities except for “slight clumsiness” of her left hand. f CT scan with minimal residual ischemic changes. MCA, middle cerebral artery; CBF, cerebral blood flow; CBV, cerebral blood volume