PMC8481822_01
Pre-treatment computed tomography scan at cranial (A) and chest (B). The pre-treatment computed tomography scan at cranial indicated obvious cerebral tissue edema, ventricle compression, and subarachnoid hemorrhage. The pre-treatment computed tomography scan at chest found bilateral infection with pleural effusion in lung.
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F1
An initial computed tomography scan showed large infarcts and subarachnoid hemorrhage in the left frontal, temporal, occipital, and basal ganglia areas of the brain (Figure 1).
Pre-treatment axial magnetic resonance imaging at T1WI (A), T2WI (B), Flair (C), DWI (D), and ADC (E) sequence. Pre-treatment axial magnetic resonance imaging indicated there were long T1 and T2 signals, flair hypersignal, mild limited DWI, and ADC hypersignal in the left occipital lobe and basal ganglia.
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F2
The initial axial cerebral magnetic resonance imaging showed an area of vasogenic edema within the cortex, basal ganglia, and the subcortical white matter of the parieto-occipital lobes (Figure 2).
Pre-treatment digital subtraction angiography imaging at anterior (A), posterior (B), and lateral (C) projections. Pre-treatment digital subtraction angiography imaging indicated hyperplastic angiography at the end of the internal carotid artery, resembles a puff of smoke rifting in the air.
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F3
Cerebral angiography and digital subtraction angiography were performed and moyamoya disease was diagnosed based on results (Figure 3).
Computed tomography (A) and magnetic resonance imaging (B,C) after treatments. Computed tomography suggested the edema was disappeared, and the subarachnoid hemorrhage was absorbed after treatments. Magnetic resonance imaging found T2 hypersignal was disappeared, and the DWI signal without hypersignal shadow.
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F4
Moreover, cerebral magnetic resonance images were normal after treatment (Figure 4).