We report a 62-year-old Chinese man who presented 90 minutes after right-sided weakness and inability to speak of sudden onset. He had been taking medications for hypertension and hypercholesterolaemia for 5 years. On examination, he was conscious with an irregularly irregular pulse and blood pressure of 168/95 mmHg. Neurological examination was remarkable for a forced left gaze, global aphasia and profound right hemiplegia (Power, Medical Research Council – MRC grade 0) with the National Institute of Health Stroke Scale (NIHSS) score of 23 points. While no early ischaemic changes were noted in the non-contrast-enhanced brain computed tomography (CT), CT angiography (Fig. 1A) revealed an occlusion of left proximal middle cerebral artery (MCA).
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