PMC5216156_01
a: FLAIR-MRI on admission showing a left parietal cortical subarachnoid hemorrhage (small white arrow), multiple lesions on the bilateral occipital lobes (large black arrows), and traumatic scalp hematoma (black arrowhead). b: MRA on admission showing no abnormalities. c: FLAIR-MRI on Day 6 showing the resolution of the occipital lesions. d: MRA on Day 6 showing a beaded appearance of the bilateral middle and posterior cerebral arteries (white arrows). e: FLAIR-MRI on Day 14 showing no additional findings. f: MRA on Day 14 showing the resolution of the narrowing vessels.
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Magnetic resonance imaging (MRI) of the brain using fluid-attenuated inversion recovery (FLAIR) revealed a left parietal cortical subarachnoid hemorrhage (SAH) (Fig. 1a, small white arrow) and multiple high-intensity lesions in the bilateral occipital lobes (Fig. 1a, large black arrows). Diffusion-weighted MRI and magnetic resonance angiography (MRA) revealed no abnormalities (Fig. 1b). On Day 6, MRA showed narrowing of the bilateral middle and posterior cerebral arteries (Fig. 1d, white arrows), although the lesions on the occipital lobes had improved (Fig. 1c). On Day 14, her headache had improved, and findings on MRI and MRA were normal (Fig. 1e and f).
PMC5216156_02
a, b: MRA on admission showing no abnormalities. c, d: MRA on Day 7 showing a diffuse, beaded appearance of the intracranial vasculature (white arrows). e, f: MRA on Day 25 showing the complete resolution of the narrowing vessels.
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The brain MRI with MRA findings were also normal (Fig. 2a and b). A repeat MRI with MRA performed on Day 6 after her discharge showed narrowing of the bilateral anterior, middle, and posterior cerebral arteries (Fig. 2c and d, white arrows), which were normalized on Day 25 (Fig. 2e and f).