Axial FLAIR images show subtle hyperintensity in the white matter of posterior right temporal/occipital lobes.
Left: Axial FLAIR images show increase in size of the hyperintensity in the same region.
Right: Post contrast T1WI shows mild enhancement of the lesion.
Upper left: Post contrast Coronal T1WI demonstrates gyriform enhancement of the right parietal
and posterior temporal lobes.
Right: Multivoxel spectroscopy shows elevated choline and decreased NAA with increased lipid
and lactate peaks in the right posterior parietal region, compared to the more normal left side.
Left: DWIs reveal restricted diffusion of the lesion that is confirmed by low intensity in
the corresponding ADC map.
Right: MRA of COW show severe stenosis of the M1 segment of the right MCA with decreased
Key words: mri mrs mra dwi vascular stroke infarction ischemia
Middle cerebral artery stenosis
with cortical & deep white matter infarcts