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Highlights Clinical symptoms suggestive of delayed post-hypoxic leukoencephalopathy (DPHL) can be observed in very rare cases following successful revascularization therapy in large vessel occlusions, causing acute ischemic stroke. Radiological signs of DPHL may be subtle, can be unilateral, and therefore can be easily overlooked. Repeated controls using magnetic resonance imaging (MRI) is necessary to correlate and monitor the clinical course and the morphological changes of the brain over time.