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CTA shows no intracranial occlusion or stenosis. There is calcified and noncalcified plaque at the right cervical ICA resulting in severe stenosis (@Key Finding 1).

@Key Finding 2 shows a large TMAX deficit in the right MCA/ACA and MCA/PCA borderzone without a calculated infarct core (you can see a matched defect on the left corresponding to old infarct). Given the above high grade right carotid stenosis, we can compare MTT to TMAX to see if we're dealing with a compensated delayed transit or an acute on chronic insult. While the MTT is much more normal than TMAX, there are a few regions where there is also an MTT deficit (@Key Finding 4) consistent with acute on chronic hemodynamic compromise.

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EDNeuroRad

Uploaded 8 months ago

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