Fig. 3

A-63 years-old female patient, with a history of cardiac disease, complained of disturbed level of consciousness and right hemiparesis two hours before visiting the emergency unit. No chest symptoms were reported. Urgent non-contrast brain CT was unremarkable on admission. Brain MRI was performed after two hours. Hypo-intense signal was noticed at the left temporal cortical and subcortical white matter in T1-WI [A]. A subtle cortical hyper-intense signal was barely noticed in T2-WI [B] and FLAIR-WI [C]. Positive diffusion restriction was noted in the form of a bright DWI signal [D] and a corresponding low ADC value in the ADC mapping [E] (orange arrows). Coronal T2-WI revealed non-visualization of the signal voids of the left ICA and MCA (red circle) [F] The initial diagnosis was a recent ischemic infarction along the left MCA territory