March 1, 2012
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A 12-year-old boy with an unremarkable familial and medical history presents with global aphasia and right hemiplegia 14 days after a streptococcal pharyngeal infection. A neurological examination performed three hours after symptom onset reveals a conjugate gaze deviation to the left, right hemiplegia, hemihypesthesia, and extensor plantar sign. The NIHSS score is 22. Laboratory examinations are normal. A cerebral CT shows a hyperdense left MCA and early signs of infarction in that area.