Bilateral Anterior Circulation Stroke

A 70 y o male admitted for stroke evaluation.

Here is MRI Brain diffusion with MR Angio.

MRI Brain Diffusion shows bilateral hemispheric restricted diffusion suggestive of an acute ischemic infarct, involving bilateral peri sylvian cerebral cortex, insular cortex and basal ganglia (bilateral MCA proximal main stem territory), para sagittal fronto parietal cortex (bilateral ACA territories).
Bilateral medial occipital lobes, mesial temporal lobes and thalami (PCA territory) spared.

On Non contrast 3 D TOF brain and 2 D TOF neck angio both the ACAs and MCAs not visualized  Neck angio suboptimal as pt was non coperative.

Diagnosis : Anterior circulation stroke - Simultaneous bilateral hemispheric infarcts / Bilateral ACA - MCA territory.