PMC5364904_01
(A) Pre-operative magnetic resonance angiography (MRA) revealed right internal carotid artery (ICA) occlusion. (B) Post-operative MRA revealed good bypass patency.
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F1
While a neurological examination at our facility revealed no abnormalities, magnetic resonance angiography (MRA) revealed right internal carotid artery occlusion (Fig. 1A). On Day 5 after surgery, MRA revealed good bypass patency (Fig. 1B); magnetic resonance imaging (MRI) revealed high intensity when T2-weighted (Fig. 5A ) and slightly higher intensity when diffusion-weighted (Fig. 5B); and perfusion CT revealed hyperperfusion (Fig. 3B).
Single-photon emission computed tomography (SPECT) scan revealed a perfusion defect in the right frontal (hypoperfusion) and decreased cerebrovascular reactivity in the right hemisphere on the pre-operative with acetazolamide challenge test.
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F2
A single-photon emission computed tomography (SPECT) scan, with and without acetazolamide challenge, revealed a perfusion defect in the right frontal lobe (hypoperfusion) and decreased cerebrovascular reactivity in the right hemisphere (Fig. 2).
(A) Pre-operative perfusion CT revealed at resting state revealed a perfusion defect (hypoperfusion) in the right frontal area of the right hemisphere. (B) Perfusion CT revealed hyperperfusion on Day 5 after surgery.
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F3
Perfusion computed tomography (CT) revealed hypoperfusion in the right frontal lobe (Fig. 3A). 
(A) CT revealed no abnormalities on Day 1 after surgery. (B) CT revealed a low area in a right frontal on Day 4 after surgery. (C) CT revealed the right frontal intracerebral hemorrhage at the corresponding lesion to the prior vasogenic edema on Day 8 after surgery.
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F4
The patient's postoperative course was relatively uneventful, and CT revealed no abnormalities (Fig. 4A). However, the patient suffered generalized convulsions, and CT revealed a low-density area in the right frontal lobe on Day 4 after surgery (Fig. 4B). The patient continued to experience severe left hemiparesis and disturbance of consciousness on Day 8 after surgery, due to intracerebral hemorrhage in the right frontal lobe at the site of the earlier vasogenic edema (Fig. 4C).
(A) Magnetic resonance imaging (MRI) revealed the high intensity on T2-weight on the day after Day 5 after surgery. (B) Magnetic resonance imaging (MRI) revealed slightly high on diffusion on the day after Day 5 after surgery.
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F5
On Day 5 after surgery, MRA revealed good bypass patency (Fig. 1B); magnetic resonance imaging (MRI) revealed high intensity when T2-weighted (Fig. 5A ) and slightly higher intensity when diffusion-weighted (Fig. 5B); and perfusion CT revealed hyperperfusion (Fig. 3B).