Patients with ischemic stroke (IS) who have a proximal major cerebral artery occlusion within 6 hours of the onset of symptoms are treated with mechanical thrombectomy (MT). If the patient qualifies, IV tissue plasminogen activator (TPA) and thrombectomy are the treatments for an MCA stroke. In patients with anterior circulation ELVO and an NIHSS score of 3, thrombectomy is recommended. In addition to changes owing to direct tissue damage to the insula and basal ganglia, a right MCA stroke may impair the feeling of pleasurable emotions via affecting brain activity in limbic and paralimbic regions far from the location of direct damage.