PMC6260547_01
Brain CT on presentation.
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fig1
Initial brain CT was negative for hemorrhage or any infarcts [Figure 1].
Axial CT images demonstrating bilateral large areas of hypoattenuation consistent with acute MCA and ACA infarcts.
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She had a repeat CT the next day that demonstrated large areas of low attenuation in both cerebral hemispheres consistent with acute ACA and MCA infarcts [Figures 2(a) and 2(b)].
Maximum intensity projection (MIP) axial image of the CT angiogram demonstrates severe stenosis of the internal carotid arteries (single arrows) and occlusion of the Rt, MCA (double arrows).
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ACAs were patent but diffusely decreased in caliber, and prominent lenticulostriate vessels were noted in the basal ganglia bilaterally [Figures 3 and 4].
Coronal MIP demonstrates prominent lenticulostriate collaterals in the basal ganglia (arrows).
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fig4
ACAs were patent but diffusely decreased in caliber, and prominent lenticulostriate vessels were noted in the basal ganglia bilaterally [Figures 3 and 4].