Neuro_CTA_Head/Neck: 30 M, left sided weakness.

1. Hypodensity in the right basal ganglia and insular cortex (insular ribbon sign) compatible with acute infarction. No acute hemorrhage.

2. Occlusion of the right internal carotid artery 3 cm from its origin wirth tandem ICA terminus clot. Reconstitution of the right A1 and distal right ACA branches via patent anterior communicating artery, and right MCA cortical branches ACA and PCA collaterals.

(Tandem carotid terminus and ICA origin occlusion)

3. Severe perfusion delay to the entire right MCA territory, with decreased CBV/CBF centrally, some cortical sparing of CBV/CBF suggesting tissue at risk though difficult to quantify. MRI may be obtained as clinically warranted.

(Tandem carotid terminus and ICA origin lesion with insular ribbon sign)