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Bilateral Middle Cerebral Artery Infarction

A 79 year old woman with atrial fibrillation presented with the acute onset of a global aphasia and tetraparesis.

Show the Occluded Left ICA                                     Show the Occluded Right MCA                              Show the Missing Right MCA Branches

Cerebral angiogram: (Left:  left internal carotid artery injection (AP view); Middle: right internal carotid artery injection (AP view); Right: right internal artery injection (lateral view). With the angiogram, the reason behind the bilateral MCA stroke becomes clear. The left internal carotid artery is occluded; the right middle cerebral artery is occluded (presumably from an embolus); and both anterior cerebral arteries are spared as there is an intact anterior communication artery that allows filling of the left ACA from the right hemisphere.

Revised 04/22/06.
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