A 47-year old man was last seen well at 21:30h. At 03:30h he was noted to have global aphasia and moderate right-sided weakness. He was evaluated at a comprehensive stroke center at 06:35h. His NIHSS score was 15.
The CT scan showed early infarct signs in the left middle cerebral artery (MCA) territory; ASPECT score was 5, with sparing of the deep structures (lentiform nucleus, caudate and internal capsule). CT angiography revealed an occlusion of the mid M1 segment of the left MCA.