S CT

Clinical History: 60 year old male with acute onset left hemiparesis and hemineglect. NIHSS 15 ish. LSN 1 and half hours before at 1900 hrs.

NCCT: 20 40 hrs. Slightly motion degraded. ASPECTS 10 ish..may be insula involved. Hyperdense MCA sign.

mCTA: Right distal M1 occlusion. Right cervical ICA unstable plaque with 50% stenosis.

           Collaterals: Fair. Good extent with delayed washout.

            Arch anatomy: Not difficult.

IR: Puncture time: 21 29 hrs. Solitaire 4x 30 mm, One pass. TICI 2b. No complications. Nothing done for cervical carotid artery.

24 hr f/u: Small areas of acute infarcts in insula, M2 and m5. No hemorrhage.

Clinical f/u: NIHSS 5 ish.