Acute ICA ischemic penumbra due to high-grade CCA stenosis (CT perfusion)

Discussion:
  • no hemorrhage or signs of acute infarction. No large vessel occlusion
  • severe complex right CCA bifurcation/proximal ICA atheromatous plaque causing high-grade stenosis and near-complete occlusion
  • single right vertebral artery supplies the basilar artery, with a high-grade atheromatous stenosis of V4
  • perfusion color maps demonstrate increased time parameters reflecting penumbra in the right cerebral hemisphere due to the high-grade stenosis of the ICA. These changes could also be secondary to seizure but there was no indication of this in the clinical presentation. No core infarct identified
  • old right ACA infarction

The patient was not suitable for IV thrombolysis.

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