This case demonstrates acute changes with acute MCA territory infarct:

• hyperdense MCA sign
• loss of grey-white differentiation, seen earliest in the insular cortex and basal ganglia

Perfusion imaging is more commonly performed to calculate the presence and size of the ischemic penumbra (i.e. cerebral parenchyma at risk of infarction but not yet infarcted) through which various interventions (e.g. thrombolysis, clot retrieval, etc) can be considered for treatment with the aim of improved outcomes.