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Clinical Reasoning: An 82-year-old woman with dissociated aphasia followed by amnesia

An 82-year-old right-handed woman presenting with a sudden-onset language deficit was initially evaluated in a regional hospital, with an unremarkable head MRI with gadolinium and progressive full recovery of the language deficit. Two hours later, she presented a second episode of aphasia and was transferred to our department for evaluation of IV thrombolysis (within a European time window of 4 hours and 30 minutes), arriving 1 hour and 40 minutes after symptom onset.