65 year-old female who presented the night before with 1 hour TIA (R face, arm, global aphasia which resolve. Repeat event night 2. During diagnostic angio, the left MCA opened and closed several times. TPA treatment initially (12mg), followed by angioplasty. Pt. stable 2 years post. DX: Focal stenosis L M1 with superimposed thrombus.

62 year-old female presents with acute LUE>LLE hemiplegia and aphasia, 1 hour onset. Xenon shows area of decreased perfusion. RCCA angio shows string sign of RICA. Contr injection shows superior division R MCA occluded. Punched catheter thru proximal stenosis. Pre & post lysis. Endarterectomy done next day on RICA. Pt. neurologically intact. Post xenon shows reperfusion.

33 year-old female... 1-week history of worsening photophobia, diplopia and HA’s. CT reveals sagital sinus thrombosis. 48 hours of drip infusion of TPA as well as mechanical dislodging opens up torcula, proximal right transverse sinus, and deep drainage structures. Symptoms resolved.

65 year-old male with 2 hours of global aphasia and dense right hemiplegia. Left internal carotid is occluded at origin. After driving catheter through occlusion and giving TPA, thrombus demonstrated in MCA and ACA. After additional TPA and Left MCA angioplasty, intracranial vessels open. Before leaving LICA, emergent stent is placed. Mild residual expressive aphasia post with some residual right hemiparesis.