PMC7378609_01
Axial MRI brain imaging: (a):(d) images from the first episode of stroke, with regions of restricted diffusion indicative of acute ischemia (arrows), primarily noted in the right cerebral hemisphere; (e):(h) images from the second episode, with progressive bilateral ischemic changes (arrows).
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fig1
She was found to have acute cerebral ischemic infarcts primarily noted in the right cerebral hemisphere (Figures 1(a)-1(d)). On this admission, she had further progression of intracranial stenosis and ischemic infarcts noted bilaterally (Figures 1(e)-1(h)).
Digital subtraction angiography images: (a) left internal cerebral artery (ICA) with focal distal ICA and proximal M1 arteriopathy (arrows) with prominent lateral lenticulostriate branches, indicating early collateralization of flow (arrowheads); (b) right internal cerebral artery (ICA) with focal distal ICA, proximal MCA (M1), and proximal ACA (A1) arteriopathy (arrows) with prominent lateral lenticulostriate branches, indicating early collateralization of flow (arrowheads).
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ACA, MCA, and watershed territories, compatible with ischemia. A diagnostic digital subtraction cerebral angiography showed progressive arteriopathy in both ICA terminals, M1, and A1 with prominent lateral lenticulostriate branches, indicating early collateralization of flow (Figures 2(a) and 2(b)).