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FIG 1. Ipsilateral P4 sign in a 73-year-old female patient who presented with acute-onset right hemiplegia.
A, 3D TOF MRA obtained 3 hours after onset showed left M1 occlusion. Ipsilateral P4 (parieto-occipital artery) is observable over almost half of the segment (white arrows).
B, Anteroposterior view of left vertebral arteriogram shows prominent collateral flow from the PCA to the ipsilateral MCA during the capillary phase (black arrows).
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