PMC4533387_01
Diffusion-weighted magnetic resonance (MR) image demonstrating multiple fresh infarctions in both the cortical and subcortical areas of the left cerebral hemisphere, indicating the duplex of hemodynamic compromise and artery-to-artery embolism.
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F1
Magnetic resonance imaging revealed multiple small infarctions in the left cerebral hemisphere (Fig. 1).
Digital subtraction angiogram of the left common carotid artery, oblique view, clearly demonstrating severe stenosis (arrow) in the left C2 portion.
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F2
Digital subtraction angiography showed a severe stenosis in the left C2 portion of the internal carotid artery (Fig. 2) and a well-developed PAA extending to the parietal area (Fig. 3A).
Pre- (A) and postoperative (B) lateral external carotid arterio-grams demonstrating the frontal branch of the superficial temporal artery (STA, white arrows) and posterior auricular artery (black arrows). Note the absence of the parietal branch of the STA in A. Patent anastomoses and sufficient distal flow are demonstrated in B. The black dot indicates the external auditory canal.
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F3
Postoperative angiography showed good patency of the anastomoses (Fig. 3B).
Photograph showing the tracing of the superficial temporal artery frontal branch (white arrows) and posterior auricular artery (black arrows) on the skin, and the skin incision (arrowheads) marked according to the paths of the arteries.
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F4
The STA frontal branch and PAA were traced with the Doppler probe passed over the skin before the surgery (Fig. 4).