Acute Hemiparesis and Ipsilateral Supratentorial Lesion: Any Association?

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A 59-year-old man presented with acute grade 4 left-sided pyramidal weakness, which improved spontaneously over a half-an-hour period to a remarkable degree. He had a history of longstanding hypertension and hyperlipidemia for which he was taking daily ramipril and atorvastatin. Otherwise, he denied any history of headache, previous focal neurological deficits, or seizures. He reported no loss of consciousness or external injuries. After examining the patient, an urgent non-contrast CT brain scan was carried out (Figure).