07/09/2026
The normalization of Mean Transit Time (MTT), as demonstrated in perfusion images before and subsequent to angioplasty and stenting of severe stenosis of right middle cerebral artery (MCA). The angiogram prior to treatment showed retrograde filling of MCA vasculature via terminal anterior cerebral artery branches. The MCA circulation normalized with the filling becoming antegrade and robust, after intervention.
Clinically, the patient manifested remarkable cognitive improvement, greater verbal output, improved concentration, stabilization of labile affect, where she had been prone to bouts of crying (these had been attributed to her stroke) and, a happier disposition.
Unfortunately, this patient was referred only after suffering multiple strokes rendering her hemiparetic at presentation, months after dual anti-platelets had proven ineffective. She and her family are very happy with the outcome.
It may not have been, but for a thoughtful neurosurgeon who deemed it worthwhile to have another neurosurgeon with relevant expertise take a look at the patient.
