This case concerns an 83-year-old woman who was admitted to hospital for her second ischemic stroke on the right side. She had already suffered a first stroke 14 years ago on her left side. A few days before this second episode, she experienced right-sided weakness, confusion, inability to walk, control her right hand or speak normally, with a GCS score of 12. Explore the imaging findings, delve deeper into the management of this bilateral stroke.