PMC5831235_01
MRI brain reveals an area of diffusion restriction over the right MCA territory (orange arrow) with corresponding signal loss on Apparent Diffusion Coefficient (ADC) mapping (blue arrow), suggesting acute ischemic infarct.
CRINM2018-2410154.001.jpg
PMC5831235_01_CRINM2018-2410154.001.jpg
fig1
Magnetic resonance imaging (MRI) of the brain was performed while he was an inpatient, revealing a right MCA territory infarct (Figure 1).
CT angiogram of the circle of Willis showing multiple areas of luminal irregularity.
CRINM2018-2410154.002.jpg
PMC5831235_01_CRINM2018-2410154.002.jpg
fig2
As shown in Figure 2, there was bilateral moderate luminal irregularity in the M2 branches of the MCAs (more pronounced on the right, as shown by arrows) with less pronounced changes in the A2 segments of the anterior cerebral arteries and their branch vessels, raising suspicion for small to medium vessel vasculitis.