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Fig. 2B —Pretreatment and early posttreatment imaging in 64-year-old man with 2 hours of aphasia and right hemiparesis who underwent IV recombinant tissue plasminogen activator therapy within 3-hour time window recommended for IV therapy. Pretreatment axial maximum-intensity-projection image from CT angiogram (A) shows almost complete occlusion of M1 segment of the left middle cerebral artery. Pretreatment perfusion CT image (B) shows cerebral blood volume deficit (dark blue) in posterior left temporal lobe with sparing of anterior left temporal lobe. However, cerebral blood flow image (C) shows decreased cerebral blood flow and mean transit time (MTT) image (D) shows prolonged MTT (dark blue) in both anterior portion and posterior portion of left temporal lobe. Thus, posterior temporal lobe likely represents infarcted tissue (both MTT/cerebral blood flow and cerebral blood volume abnormality) and anterior temporal lobe may represent salvageable tissue or ischemic penumbra (MTT/cerebral blood flow abnormality with normal cerebral blood volume).