case_images: PMC5903121_01
case_images: MR images at 13 days after onset. Diffusion-weighted axial (upper), T1-weighted axial (middle), and T2-weighted coronal (lower) images showed a hyperintense area, suggesting hemorrhage, under the opercular part of the left precentral gyrus (area 6) that extended upward under the postcentral gyrus. T2-weighted images also showed old lacunar infarctions in the basal ganglia and periventricular white matter bilaterally.
case_images: crn-0010-0072-g01.jpg
case_images: PMC5903121_01_crn-0010-0072-g01.jpg
case_images: F1
case_images: MRI performed 13 days after onset revealed a hyperintense area under the opercular part of the left precentral gyrus (Brodmann area 6) that extended upward under the postcentral gyrus (Fig. 1).
case_images: 99mTc- ECD-SPECT images at 15 days (upper panel) and 6 months (lower panel) after onset. Regional hypoperfusion is depicted in color. The red-to-bright yellow color gradient reflects increasing Z-scores. A circumscribed area of blood flow reduction in the inferior part of the left sensorimotor cortex was noted at 15 days after onset (upper panel): areas with local maximum reduction in the Montreal Neurological Institute coordinate were area 3 (-58, -12, 24) and area 43 (-58, -14, 16). The local hypoperfusion had recovered at 6 months after onset (lower panel). The image data were first normalized, smoothed, and adjusted to compare between laboratories with the easy Z-score Imaging System (eZIS version 3.4), and were constructed using a two-sample t test: patient vs. healthy subjects aged between 40 and 59 years (n = 30) (uncorrected p < 0.001) in Statistical Parametric Mapping version 2 (SPM2). The extent threshold was set as equal to the expected voxels per cluster to avoid noise clusters.
case_images: crn-0010-0072-g02.jpg
case_images: PMC5903121_01_crn-0010-0072-g02.jpg
case_images: F2
case_images: Single photon emission computed tomography with a 99mTc-ethylcysteinate dimer (99mTc-ECD-SPECT) performed 15 days after onset showed a focal reduction of the cerebral blood flow in the lower part of the left sensorimotor cortex (Fig. 2). Local hypoperfusion of the left sensorimotor cortex recovered in six months after onset (Fig. 2).
case_images: Samples of errors in the five-character kana nonword writing test. Correct answers were illustrated as print characters. Pronunciation of the kana nonword was expressed, with each character being connected with a hyphen (in parenthesis). A phonological error denotes the substitution of another kana character due to consonant change ( [ri]    [ki]) or vowel change ( [i]    [e]). A transposition error denotes changing the sequential order of two kana characters (  [nimi]     [mini]).
case_images: crn-0010-0072-g03.jpg
case_images: PMC5903121_01_crn-0010-0072-g03.jpg
case_images: F3
case_images: Errors consisted of nine phonological errors (substitution of another kana character due to consonant or vowel change), and one transposition (the order of successive two-letter sequences transposed with each other) (footnote of Table 3; Fig. 3).