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Peter E. Turkeltaub, MD, PhD; Sarah M. Kranick, MD; Brett Cucchiara, MD

Arch Neurol. 2009;66(4):536.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 55-year-old, previously healthy woman presented with neglect and left hemiplegia 5 hours after onset of symptoms. Her deficits did not improve, and brain magnetic resonance imaging performed 36 hours after symptom onset revealed a large right subcortical infarction with cortical sparing. T2-weighted sequences showed an apparent flow void in the proximal right middle cerebral artery (MCA), suggesting normal flow (Figure). However, gradient echo sequences demonstrated a hypointense signal in the right MCA consistent with thrombus. Magnetic resonance angiography subsequently confirmed a right MCA occlusion and demonstrated a cervical internal carotid artery dissection, which was the presumed stroke mechanism. At 3-month follow-up, her neglect had resolved, but she had persistent moderate hemiparesis that affected the arm more than the leg. Her modified Rankin scale score was 3.

Figure appears in full text version. Figure. Magnetic resonance images of the middle cerebral . . . [Full Text of this Article]

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