PMC7002563_01
First brain imaging. (A) Brain CT showing ischemic-like lesions in the occipital lobes (red arrows). (B) CT scan showing hypodense lesions with breakdown of the blood-brain barrier (BBB) in the occipital lobes. (C,D) Sagittal T1 MRI showing hyperintensities in both occipital lobes. (E) Brain MRI (T2-weighted images) showing hyperintense lesions in the white matter of the occipital lobes. (F) Fluid attenuation inversion recovery (FLAIR) images showing ischemic-like lesions in the occipital lobes. (G) MRI angiographic sequences showing breakdown of BBB in the occipital lobes. (H) Diffusion sequence showing restriction in the occipital lobes. (I) Magnetic resonance angiography time-of-flight (MRA TOF) sequences showing breakdown of BBB in the occipital lobes.
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F1
Brain computed tomography (CT) showed two ischemic-like occipital lesions without hemorrhage (Figure 1).
Normal magnetic resonance (MR) angiogram. No evidence of vasospasm in the anterior of the posterior circulation.
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F2
MRI angiographic sequences did not show any abnormality in the vertebrobasilar system or in Willis polygon (Figure 2).
Follow-up images. (A,B) Sagittal T1 MRI showing hyperintensities in both occipital lobes (red arrows). (C,D) MRI fluid attenuation inversion recovery (FLAIR) images showing persistent ischemic-like lesions in the occipital lobes. (E) T2-weighted images showing hyperintense lesions in the occipital lobes. (F) Diffusion images demonstrating restriction in the occipital lobes. (G) MRI apparent diffusion coefficient (ADC) images showing residual restriction in the occipital lobes. (H) MRI angiographic sequences confirming persistent breakdown of BBB in the occipital lobes.
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F3
The radiological follow-up with MRI 1 month later showed ischemic-like parieto-occipital bilateral lesions (Figure 3).