An 86-year-old Chinese woman presented with left-sided weakness for 6 h. Her medical history included hypertension, ischaemic heart disease, atrial fibrillation and hypercholesterolaemia. She was conscious and communicative, with blood pressure 166/102 mm Hg and irregular pulse (102 beats/min). Examination showed right-gaze deviation and left-hemiparesis (Medical Research Council power grade 0 and 2 in the upper and the lower extremity, respectively, National Institute of Health Stroke Scale 11 points).

Computed tomography of the brain showed hyper-dense right middle cerebral artery (MCA) and …