Acute left hemiparesis due to middle cerebral artery occlusion. A

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Acute left hemiparesis due to middle cerebral artery occlusion. A Acute left hemiparesis due to middle cerebral artery occlusion. A. Axial noncontrast computed tomography (CT) scan demonstrates high density within the right middle cerebral artery (arrow) associated with subtle low density involving the right putamen (arrowheads). B. Mean transit time CT perfusion parametric map indicating prolonged mean transit time involving the right middle cerebral territory (arrows). C. Cerebral blood volume (CBV) map shows reduced CBV involving an area within the defect shown in B, indicating a high likelihood of infarction (arrows). D. Axial maximum-intensity projection from a CT angiography (CTA) study through the circle of Willis demonstrates an abrupt occlusion of the proximal right middle cerebral artery (arrow). E. Sagittal reformation through the right internal carotid artery demonstrates a low-density lipid-laden plaque (arrowheads) narrowing the lumen (black arrow). F. Three-dimensional surface-rendered CTA image demonstrates calcification and narrowing of the right internal carotid artery (arrow), consistent with atherosclerotic disease. G. Coronal maximum-intensity projection from magnetic resonance angiography shows right middle cerebral artery (MCA) occlusion (arrow). H. and I. Axial diffusion-weighted image (H) and apparent diffusion coefficient image (I) documents the presence of a right middle cerebral artery infarction. Source: NEUROIMAGING IN NEUROLOGIC DISORDERS, Harrison's Neurology in Clinical Medicine, 4e Citation: Hauser SL, Josephson S. Harrison's Neurology in Clinical Medicine, 4e; 2017 Available at: http://neurology.mhmedical.com/DownloadImage.aspx?image=/data/books/2207/hauserneuro4_ch4_f002b-1.png&sec=169307914&BookID=2207&ChapterSecID=169307904&imagename= Accessed: October 25, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved