FLAIR images reveal hyperintensity in the left premotor cortex. Restricted
diffusion with corresponding decreased ADC values in the left lateral frontal
lobe cortex. MRA demonstrates abrupt termination of the supraclinoid
internal carotid arteries.
Injection of the internal carotid arteries bilaterally demonstrates occlusion
of the supraclinoid internal carotid arteries with extensive collateralization.
The posterior circulation (upper right) provides extensive leptomeningeal
collaterals to the anterior circulation.
CT perfusion images demonstrate symmetrically increased MTT (lower right)
and reduced CBF (upper right) in the anterior circulation as compared to the
posterior circulation. The CBV (lower left) is increased in the anterior
circulation from dilation of the capillaries and arterioles to compensation for
the abnormal MTT and CBF. This patient has likely exhausted his vascular
reserve, and the entire anterior circulation is at risk for infarction.
Key words: mri angiography perfusion mra vascular
Moya-Moya disease -
Acute cerebral infarct