Findings:
The M2 subdivision of the left MCA is occluded. There is increased TTP without significant changes in the CBV/CBF in the left temporal and parietal lobes, suggesting a salvageable penumbra in the left MCA distribution.
There is a dissection flap and pseudoaneurysm in the left distal internal carotid artery. There is atherosclerosis at the aortic arch.

Impression:
Acute left M2 MCA stroke with salvageable penumbra on perfusion. There is also a dissection flap and pseudoaneurysm in the left distal ICA.

Recommendations:
For your training purposes, recommendations are not included in this report.