This case involves a seventy-three-year-old female patient admitted to the ER for sudden onset of right-sided weakness and aphasia. The patient was given tPA and then taken to neuro-interventional radiology for further intervention of an evolving stroke. The patient was found to have had a carotid occlusion on the left side that was cleared via interventional methods. The MCA was also severely occluded but attempts to approach this block resulted in a perforation. The patient suffered from a sub-arachnoid hemorrhage that led to cerebral edema and eventual death.