58 years old, female, patient attended the emergency room reporting sudden discomfort and loss of strength in the lower limbs followed by a fall from her own height. She reports chronic arterial hypertension, dyslipidaemia and thrombophilia (deficiency of antithrombin III). She uses Losartan and aspirin. Physical exam: good general state, vigilant, oriented in time and space, afebrile, hypertensive (180;110mmHg), absence of meningeal signs, left hemiplegia with hyperreflexia and plantar reflex indifferent to the left. It was requested a computed tomography (CT) of the cranium without contrast, a magnetic resonance (MRI) and an angioresonance of the cranium.