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Olea Medical Publications

In-depth information about Olea Medical’s innovative technologies and their impact in improving patient care and diagnostic confidence.

Olea Imagein Magazines

  • Predictive Imaging

  • Clock Around The Stroke

  • Big Bang Data

  • Back to The Future Saga

  • MRevolution

  • The Diffusion Saga

  • The Bayesian Saga

  • Imaging Biomarkers

Predictive Imaging

Predictive imaging allows us to dream, realize the full potential of imaging, and could facilitate to achieve personalized medicine. In this 7th issue of Olea Imagein magazine, discover what experts think of the predictive value of imaging in the fields of neurology, mammography or even cardiology.


Clock Around The Stroke

Can we move from too-little-too-late to widespread timely effective care? In this issue, world leaders in the field present their opinions on key issues related to the ticking clock faced by every stroke patient. Ischemic stroke is the third leading causes of death in the world. While a slight decrease in the incidence has been observed in the past decades thanks to preventive therapies that address major risk factors such as high blood pressure, the prevalence continues to grow with the aging population.


Big Bang Data

Artificial Intelligence has grown and developed dramatically over the past few years, offering groundbreaking changes in many areas, including medical imaging. In this fifth issue of Olea Imagein magazine, broad skills experts reveal the keys to better understand and master this phenomenon. From Big Data to Machine Learning through Virtual Reality or Fingerprinting, discover the deep transformations initiated in medical imaging.


Back to The Future Saga

MRI has the highest potential to literally change the paradigm in diagnosis and patient care. Therefore, the idea behind the third issue of Olea Imagein is to relay our vision of MRI tomorrow, and the vision of experts who shape today. In this third edition, discover the Dreams of several international experts about the future of MRI, those who challenge us every day to make our and their dreams come true.



MRI holds a central role in the forthcoming medical revolution, the one that will transform in-depth the diagnostic and curative potential of imaging. In this 4th edition of Olea Imagein, read about the promising technologies everyone is talking about, presented by the experts who are already using them: from GlucoCEST to texture analysis, from Sindex to Kurtosis as well as from Synthetic MRI to functional MRI.


The Diffusion Saga

Diffusion imag­ing covers a broad spectrum of techniques, from the mapping of apparent diffusion coefficient (ADC) values to diffusion tensor imaging (DTI), Intravoxel incoherent motion (IVIM) or Kurtosis imaging. All these applications are based on a single physicochemical property: water motion at the cellular level. In this second edition of Olea Imagein, Olea Medical® reveals all the secrets of this technique and its potential future applications.


The Bayesian Saga

The Bayesian method is a probabilistic method based on Bayes’s theorem, published in the 18th century. Bayesian framework can be applied in any context where parameters estimation is required and noise level is a limitation. This technique represents an indisputable breakthrough and a game changer in perfusion imaging as well as diffusion and so much more. In this first edition of Olea Imagein, Olea Medical® reveals all the secrets of this unparalleled algorithm and its positive impact on both MRI and CT image post-processing.


Imaging Biomarkers

Imaging biomarkers can predict patients at risk of developing a disease, detect pathologies, grade the aggressiveness of tumors and assess the response to treatment. In this 8th issue of Olea Imagein magazine, follow radiologists and experts into a new dimension, where imaging bio-markers significantly reshape the clinical research field towards precision medicine and better patient-centric care.


Did You Know?

  • DCIS (Ductal Carcinoma In Situ)

  • Mesothelioma

  • Central Nervous System Primary Lymphoma

  • Prostate Cancer

  • Sickle Cell Disease

  • Brain Iron Overload in Type 2 Diabetes

  • GBCAs: Gadolinium-Based Contrast Agents

  • Parotid Gland Cancer

  • Scoliosis

  • Epilepsy in Sturge Weber’s Syndrome (SWS)

  • Prostatitis

  • Cervical Cancer

  • Brain Injuries

  • Knee Osteoarthritis Follow-Up After Platelet-Rich Plasma Treatment

  • Breast Cancer in Paget Disease

  • Stroke

  • Facial Nerve Schwannoma

  • Ischemic Stroke Physiopathology

  • Tuberculous Meningitis

  • Borderline Ovary Tumor

  • Dilatation of Virchow-Robin Perivascular Spaces

  • Mucinous Carcinoma of the Breast

  • Glioblastoma

  • Sarcoma of Soft Tissues

  • Desmoid-type Fibromatosis of the Breast

  • Prostate Adenocarcinoma

  • Radiation-Induced Soft Tissue Sarcoma

  • APT CEST Imaging

  • Olea Developer Platform Project

DCIS (Ductal Carcinoma In Situ)

DCIS is the most common type of non-invasive breast cancer. Ductal means that cancer starts inside the milk duct; carcinoma refers to any cancer that begins in epithelial tissues (structural tissue cells) or other tissues (including breast tissue) that cover or line the internal organs; and “in situ” means “in its original place”. Thanks to Olea Medical’s Breast application, semi-automatic segmentation of the lesion volume and subtraction dynamic phases successively allow a morphological and multi-parametric analysis.



Mesothelioma is a rare malignant tumor that affects mesothelial cells, a protective membrane that covers most of the body’s internal organs including the pleura, peritoneum and pericardium. This tumor can develop from the membrane that surrounds the lungs (the pleura), the heart (the pericardium), the intestines (the peritoneum), the testicles and the ovaries. The multiparametric study including the DWI, Permeability and Analysis plugins in Olea Sphere®, will make it possible to differentiate the tumor (mesothelioma), fibrosis, pleural effusion and possible hemorrhages.


Central Nervous System Primary Lymphoma

Primary cerebral lymphomas are mostly non-Hodgkin’s lymphomas of type B to large cells. Cerebral lymphoma can occur at any age, with a peak frequency of around 65 years. It is a malignant tumor that develops in the brain from B lymphocytes from the lymphatic system. Olea Medical’s Brain Tumor Streamlined application allows a morphological analysis thanks to semi-automatic segmentation and a multiparametric analysis.


Prostate Cancer

MRI is necessary for the pre-operative assessment of prostate cancer. The MRI Protocol is made of 3 sequences: one T2 weighted sequence, one diffusion weighted sequence (DW) and sometimes one dynamic contrast enhanced sequence after gadolinium injection (DCE). Olea Medical’s Prostate application makes it possible to access to morphological information and parametric maps such as ADC. And thanks to our IVIM plugin, diffusion images can be computed for high b values.


Sickle Cell Disease

Sickle cell disease (also called sickle cell anemia) is widespread throughout the world. The severity varies widely among individuals, and symptoms can occur from the age of three months. Sickle-cell anemia can be investigated by MRI if the risk of cerebral infarction is suspected (clinical signs, high blood flow in Transcranial Doppler in children). The anatomical MR sequences will show chronic lesions (silent infarcts, signs of small vessel lesions) or recent ones. Olea Vision will enhance the visualization and analysis of the circle of Willis (thin-slab MIP reconstruction or 3D MIP) looking for probable stenosis.


Brain Iron Overload in Type 2 Diabetes

Type 2 diabetes, also known as non-insulin dependent diabetes, is the most prevalent and most insidious form of the disease, representing 90% of cases. It is well-known that there are bi-directional relationships between the brain, obesity and insulin resistance. Iron overload is significantly increased in obese subjects and iron seems to play a direct and occasional role in the pathophysiology of type 2 diabetes. In MRI, T2 and R2 are sensitive markers of the iron content in tissue. The quantitative study of T2 and R2 in Olea Sphere® makes it possible to estimate iron loading in the brain.


GBCAs: Gadolinium-Based Contrast Agents

Gadolinium-based contrast agents (GBCAs) have been considered safe for many years. The disadvantage of GBCAs was faced by patients with severe kidney disease only and it was linked to the development of Nephrogenic Systemic Fibrosis, or NSF. However, recent reports have shown gadolinium accumulation in neuronal tissues and other tissues, including bone and kidney. Olea Sphere® offers several plug-ins to limit or avoid the use of contrast agents.


Parotid Gland Cancer

The parotid glands are the largest of the three pairs of salivary glands (sublingual and submandibular glands are the other two). Parotid tumors are rare and often benign, but they may be malignant. Olea Sphere® offers a multiparametric analysis and display (Permeability maps, T1, T2, ADC) which makes the simultaneous analysis of the information provided by MRI easier. By placing a region of interest (ROI) at the center of the tumor, quantitative values that characterize the tumor can be obtained.



Scoliosis is a three-dimensional abnormality that occurs when the spine becomes rotated and curved sideways. The condition is characterized by a local (vertebrae) and global (spine) deformity pattern, simultaneously altering the vertebral shape and the spine balance and posture. ln Olea Vision™, the CPR (curvilinear reconstruction) functionality allows to reconstruct a new plane following a path defined by the technician. In the case of scoliosis, this will allow better analysis in a corrected image.


Epilepsy in Sturge Weber’s Syndrome (SWS)

Sturge-Weber syndrome, also called neurocutaneous angiomatosis, is a congenital vascular malformation characterized by facial capillary malformation, with variable ocular and neurological disorders. The estimated incidence of SWS is 1 case per 50,000. MRI imaging is useful for the diagnosis and evaluation of brain damage in SWS. In our Olea Vision™ module, MPR (Multi-Planar Reconstruction) and MIP (Maximum Intensity Projection) are particularly adapted to visualize and analyze the data.



Prostatitis is the name given to a set of symptoms that usually caused by infection or by inflammation of the prostate. This disease is more common in younger and middle-aged men, usually between 30 and 50 years. Prostatitis affects about 10-14% of men. The DWI and Kinetics plugins in Olea Sphere® can be used to process prostate cases.


Cervical Cancer

Cervical cancer is the 3rd most common gynecological cancer that affects young women. There are 471,000 new cases/year in the world. MRI is a complementary imaging technique useful for evaluating indeterminate masses by ultrasound. Olea Medical’s Female Pelvis application allows to visualize the morphological images and to calculate parametric maps. Multiparametric display facilitates simultaneous interpretation of images, positioning of regions of interest and provides quantitative analysis of the tumor.


Brain Injuries

There are two types of brain injury: traumatic and following cardiac arrest. Traumatic brain injury (TBI) occurs when a sudden trauma causes damage to the brain by direct brain shock. TBI is a major cause of mortality and morbidity in young people, and their incidence is increasing in people aged 65 years and older. Cardiac arrest (CA) is a major cause of mortality and neurologic disability.


Knee Osteoarthritis Follow-Up After Platelet-Rich Plasma Treatment

Knee Osteoarthritis (OA) is a chronic joint disease characterized by progressive destruction of joint cartilage leading to pain and loss of function. The interest of knee cartilage T2 mapping has been documented in various publications and this technique is a hot topic of clinical and research studies. The cartilage application in Olea Sphere® can be used for that purpose.


Breast Cancer in Paget Disease

Paget disease of the breast (also known as Paget disease of the nipple) is a rare form of breast cancer involving the skin of the nipple. It is characterized by infiltration of the nipple-areolar complex by adenocarcinoma cells. The fast and automatic computation of SER, Ktrans, Peak and Vp maps within Olea Sphere® allows to detect the under-nipple extension and reveal the pathological nature.



Stroke is the second most common cause of morbidity worldwide (after myocardial infarction). Olea Sphere® makes it possible to estimate volumes of interest including the volume of the region where ADC is lower than a given threshold and the volume of the region where Tmax is greater than a given threshold. And in neuro-vascular emergencies, Olea Sphere® saves time by providing access to all the information the clinician needs for decision making in less than a minute.


Facial Nerve Schwannoma

Schwannoma or neuroma of the facial nerve is a rare benign tumor. It represents between 0.2 to 1.5% of cases of all intra-petrous tumors. Olea Sphere® offers a multiparametric analysis and display (Permeability maps, T1, T2, ADC) which makes the simultaneous analysis of the information provided by MRI easier. By placing a region of interest at the center of the tumor, one can thus obtain quantitative values that characterize the tumor.


Ischemic Stroke Physiopathology

Stroke is defined as a sudden-onset neurological deficit caused by ischemia or hemorrhage in brain. Ischemic stroke represents approximately 87% of all strokes, it is caused by the localized occlusion of a vessel leading to a cessation of oxygen and glucose supply to the brain, resulting in a collapse of metabolic processes in the affected territory. Olea Nova Move™ allows to visualize dynamic contrast agent arrival to the brain tissue. This "pseudo-angiography" effect can be used to identify an occlusion of one of the main intracranial arteries as well as the collateral circulation status.


Tuberculous Meningitis

Tuberculosis remains a common disease worldwide. After a period of decline, its incidence is growing again, and resistant forms develop. It usually occurs in the young adult, with a majority of cases before the age of 30. Brain Tumor module within Olea Sphere® provides quick access to all perfusion maps, ADC and anatomical exam sequences. The fusion of anatomical images and calculated maps improves the visualization and the relevance of the analysis of the pathological zone. Olea Vision™ module provides good visualization and analysis of small lesions.


Borderline Ovary Tumor

Borderline ovary tumors usually affect young women and are symptom-free. This type of tumor is different from cancer. This article will help you to understand the differences and how to distinguish borderline lesions from other types of lesions. About 15 out of every 100 (15%) ovarian tumors are borderline tumors. Olea Medical’s IVIM application makes it possible to calculate diffusion-weighted synthetic images (high b values) in order to facilitate the visualization of most of the tissue portions of the lesion.


Dilatation of Virchow-Robin Perivascular Spaces

Our Olea Vision™ module provides good visualization and analysis of Virchow and Robin spaces dilatations from an isotropic FSE T2 sequence acquired in the three planes as well as the visualization of hydrocephalus. The MPR (Multi-Planar Reconstruction) and MIP (Maximum Intensity Projection) tools, also provided by this module, are particularly suitable for viewing and analyzing images.


Mucinous Carcinoma of the Breast

Olea Medical’s breastscape® suite brings together, within a single multimodal interface, all the tools needed for diagnosis, follow-up and biopsy of a high-risk breast lesion. Indeed, breastsApp offers a rapid morphological review, giving the radiologist all advanced visualization tools such as dynamic 3D MIP, MPR and subtraction. Automatic computation and analysis of semi-quantitative T1-weighted perfusion maps such as Peak Enhancement and Curve Washout allow, using a predefined threshold, to identify and segment the lesion.



Glioblastoma accounts for 15 to 20% of brain tumors. Its average survival is 18 months. 70% of glioblastomas occur between 45 and 70 years old. Glioblastomas predominate in men in a ratio of 1.5 to 1.8 / 1. The Olea Sphere® Perfusion (DSC) and Diffusion plugins can be used in addition to conventional sequences to assess brain tumors.


Sarcoma of Soft Tissues

Olea Vision™ makes morphological review easier which is a major step in the evaluation of soft tissue sarcomas. Measurement or volumetric tools are available for monitoring these tumors, in particular using tumor response criteria "RECIST 1.1". The multiparametric analysis provides additional information about the architecture, the vascularization and their changes during treatment.


Desmoid-type Fibromatosis of the Breast

Olea Medical’s breastscape® application for breast MRI interpretation includes morphological analysis of conventional sequences (T2, dynamic T1, DWI). The subtracted images (from dynamic T1 sequence) are instantly calculated and displayed when the application is launched (Figure 2) as well as several parametric maps as SER (signal enhancement ratio), Peak, AUC (area under contrast curve), PEI (positive enhancement integral), Wash-in, Wash-out, TME (time to maximum enhancement) and curve washout.


Prostate Adenocarcinoma

Olea Sphere® MR prostate application includes advanced multiparametric analysis. Conventional, diffusion and permeability maps are computed instantly and displayed in one simple click. The fusion of T2w and diffusion images improves the visualization and the relevance of the pathological zone. Lesion and prostate volume can also be computed through the semi-automatic 3D segmentation. To optimize the diagnosis workflow, PI-RADS 2.0. report is included in the application, with a possible export to PACS.


Radiation-Induced Soft Tissue Sarcoma

Olea Vision™ makes DWI and T2 morphological image fusion straightforward which facilitates the visualization of anatomical structures between the tumor and the surrounding organs. The IVIM module and synthetic B computation generate even more diffusion-weighted new images that allow a sharp differentiation of the necrosis as well as the tissue component of the lesion.


APT CEST Imaging

Olea Medical® is one of the partners of the Horizon 2020 GLINT (external hyperlink : - new tab) project (GlucoCEST Imaging in Neuroplastic Tumors), aiming at developing new CEST-based tools for more accurate and reliable cancer diagnosis tools. One of the aims of Olea Medical® in the project is to develop a CEST Application in Olea Sphere® - using its dedicated Software Development Kit (SDK) – able to process and compare the clinical/preclinical data of different partners, based on different CEST methodologies and protocols.


Olea Developer Platform Project

The Olea Developer Platform project was conceived in January 2016 from the need to integrate research work into an industrial and clinical platform. In 2018, Olea Medical® achieved 10 years of architecture enhancement, and this evolution has enabled us to create a simple and user-friendly SDK for researchers and engineers working in medical imaging and image processing.


Case Reports

  • Women’s imaging: Breast Cancer

  • Traumatic Brain Injury

  • Prostatitis with Mild Chronic Inflammation

  • Head & Neck: Parotid Pleomorphic Adenoma

  • Metastatic Pancreatic Cancer

  • Lower Limb Sarcoma

  • Granulomatous Prostatitis

  • Head & Neck: DWI and IVIM in the Orbit at 3T

  • Brain: Glioma

  • Brain Tumor: Low Grade & High Grade Gliomas

  • Stroke: Fronto-insular MCA occlusion

  • Stroke: Left MCA Occlusion with Hemorrhagic Conversion

  • Moya-Moya

  • MRI-Guided Thrombolysis of a Wake-Up Stroke

  • Stroke: Early Complete MCA Recanalization

  • Stroke: Left M1 Occlusion and Minor Peri-insular Infarct

  • Stroke: MCA occlusion

  • Brain Tumor: Glioblastoma with Oligodendroglial Component

  • Brain Tumor: Low-Grade Glioma

  • Brain Tumor: Meningioma & Primary Malignant Lymphoma

  • Brain Tumor: Pilocytic Astrocytoma

  • Stroke: Right Distal M1 Occlusion

Women’s imaging: Breast Cancer

A 37-year-old non-menopausal patient, no personal or family history of mammary or ovarian neoplasia, referred for assessment of an ACR5 mass of the LIQ of the right breast associated with suspected right axillary node (hypermetabolic PET positive lesions). The patient also has a mass type ACR 4b of LIQ of the left breast.


Traumatic Brain Injury

19-year-old male, severe head trauma after a motorcycle accident occurred 2 days before. Brain computerized tomography scans (CT) revealed a hemorrhagic lesion in the brainstem. Damage from traumatic brain injury can be focal or diffuse. Diffuse trauma to the brain is frequently associated with concussion, diffuse axonal injury.


Prostatitis with Mild Chronic Inflammation

61-year-old man with clinical history of prostate cancer (pT2N0. Gleason 3+4 and PSA [Prostate Specific Antigen] 9 ng/ml) was treated with brachytherapy (BT) eight years ago. Two years later from initial treatment, PSA value was 0,39 ng/ml. Actually, the patient presents high serum PSA level: 3,49 ng/ml. A PET-CT choline suggests local recurrence. An MRI is performed using conventional sequences, diffusion weighted imaging (DWI) and dynamic contrast enhancement (DCE).


Head & Neck: Parotid Pleomorphic Adenoma

46 year-old man, non smoker, with a right parotid mass detected several months ago. The mass is solid but mobile, the patient shows no weight loss, nor pain or facial paralysis. An MRI is performed using conventional sequences, diff usion weighted imaging (DWI) and dynamic contrast enhancement (DCE).


Metastatic Pancreatic Cancer

A 69-year-old male patient with a metastatic pancreatic cancer was included in a phase 1 study. Pancreatic ductal adenocarcinomas (PDACs) are highly metastatic with poor prognosis, mainly due to delayed detection (Ref. 1). An MRI was performed before and after treatment, including diffusion-weighted imaging (DWI) with 6 b-values (0, 50, 200, 400, 600 and 800 s/ mm2).


Lower Limb Sarcoma

60-year-old man, self-examination of a mass in the posterior right thigh. Referred to pre-surgery examination.


Granulomatous Prostatitis

67-year-old man with a history of recurrent superficial bladder tumor. Treatment by bladder instillations of BCG (Bacillus Calmette-Guerin) was started. Six months after the last instillation (the sixth), a rise in PSA level from 3 to 6 ng was noticed, confirmed by a repeat testing. Digital rectal examination showed a prostate firmness, predominantly on the right lobe. A prostate MRI was indicated.


Head & Neck: DWI and IVIM in the Orbit at 3T

A 38-year-old woman presented with rapidly worsening, painless monocular vision loss of her left eye, which began six months prior to the encounter. The clinical exam revealed a visual acuity of 1.4/10 and a central scotoma in the left eye. Oculomotricity was normal. An MRI was performed.


Brain: Glioma

Multiparametric MRI in brain tumours is an invaluable methodology for obtaining in-depth information for the structural and functional tissue features guiding the differential diagnosis and assisting the tumour staging.


Brain Tumor: Low Grade & High Grade Gliomas

Gliomas are the most common primary cerebral neoplasms. The grading of gliomas is of utmost clinical importance as it determines the correct therapy. More aggressive treatment planning is required for the management of high-grade tumors. The purpose of this case report is to illustrate the possible predictors which might discriminate between low-and-high grade gliomas using dynamic contrast-enhanced (DCE) perfusion in the follow-up of treated low grade gliomas.


Stroke: Fronto-insular MCA occlusion

A 73yo woman presented with acute onset left hemiparesis with confusion and imbalance. BP was 188 – 88mmHg and medical history showed diabetes. Upon arrival, GCS eye subscore was 3, GCS verbal sub-score was 4 and GCS motor subscore was 4.; EEG was abnormal due to an underlying structural lesion in the right fronto-temporal region.


Stroke: Left MCA Occlusion with Hemorrhagic Conversion

A 64yo man with an important history of smoking presented a sudden onset of right hemiparesis and global aphasia while watching TV with his wife. The patient was taken to an the hospital and received a CT head negative for a bleed.



34-year old female with neurofi bromatosis and Moya Moya intracerebral arterial occlusive disease. Perfusion imaging was performed with 6 ml Gadavist at 4 ml/sec. MRA shows occlusion of the right PCA and left A1 segment as well as a long segmentsignificant stenosis of the right supraclinoid ICA.


MRI-Guided Thrombolysis of a Wake-Up Stroke

An 82 year-old man with a history of hypercholesterolemia, experienced Broca’s aphasia and right hemineglect with hemihypoesthesia when waking up at 5:30 am. Upon arrival at the hospital, his BP was 200 - 100 mmHg with an NIHSS score of 7. The ECG showed a QS complex from V1 to V5 with no chest pain. MRI was performed 4.3 hours after waking up. FLAIR and T2* images were normal. CBV was increased inside the area of decreased CBF (autoregulation).


Stroke: Early Complete MCA Recanalization

A 45yo woman presented a sudden left hemiparesis with dysarthria. BP was 150 – 85 mmHg and medical history showed no vascular risk factor. Upon arrival, the NIHSS score was 6 and the ECG was normal.


Stroke: Left M1 Occlusion and Minor Peri-insular Infarct

The patient was a 42-year-old previously healthy man who was last seen normal at 10pm upon going to sleep. He complained of some nonspecific neck and jaw pain that night. The following morning, the patient’s wife was unable to encourage the patient out of bed.


Stroke: MCA occlusion

This patient is a 54yo African American man with a significant medical history of hypertension, diabetes (non-compliant with medical care), renal failure (GFR 30), obesity, and hepatitis A and C who was found lying on his couch with dense left hemiparesis and dysarthria.


Brain Tumor: Glioblastoma with Oligodendroglial Component

A 15-year-old boy presented with headache for 1 month and vomiting in the morning for a few weeks. On neurological examination, bilateral papiloedema, bilateral paresis of the 6th cranial nerve and hemianopia were found.


Brain Tumor: Low-Grade Glioma

A 51-year-old woman with a history of LED and thyroid insufficiency, complained of continuous headache and chronic fatigue. An MRI examination in an outside hospital was performed. She then was referred to a neuro-oncologist.


Brain Tumor: Meningioma & Primary Malignant Lymphoma

This is an interesting case report demonstrating the usefulness of perfusion-weighted MRI maps for the characterization of multiple intracranial masses in a patient presenting with cerebral lymphoma.


Brain Tumor: Pilocytic Astrocytoma

This is an interesting example of how leakage correction works. The final diagnosis, pilocytic astrocytoma, is fairly straight forward. These tumors are usually described as having low cerebral blood volume, a misconception caused by the rupture of the blood brain barrier and the leakage of contrast in the interstitial medium. When corrected for agent contrast leakage the real CBV value is much higher than the uncorrected one.


Stroke: Right Distal M1 Occlusion

An 84-year-old woman who woke up with left sided weakness. The last well-known time was 21:00 the night before. The admission NIHSS was 7.