case_images: PMC9729246_01
case_images: Cranial computed tomography (CT) scan. CT scan showed multiple cerebral infarction, white matter degeneration, brain atrophy, with no sign of cerebral hemorrhage or space-occupying lesion.
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case_images: F1
case_images: Cranial CT scan was performed immediately and showed no evidence of intracranial hemorrhage but multiple old infarcts, white matter degeneration, and brain atrophy (Figure 1).
case_images: Comparison of magnetic resonance imaging (MRI) T2 flair sequence. (A) 4 years ago patient suffered from moderate headache and performed MRI scan in our clinic department. It showed multiple ischemic infarcts, white matter degeneration, brain atrophy, with no sign of abnormal signal. (B) 24 h after neurological symptoms, right parietal and occipital cortex swelling with abnormal signals was observed. (C) 72 h after neurological symptoms, right parietal and occipital cortex swelling with abnormal signals remained. (D) 12 days after neurological symptoms, abnormal signals disappeared. (E) 50 days after neurological symptoms, no sign of new abnormal signal.
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case_images: F2
case_images: Urgent brain MRI showed multiple ischemic and infarct foci, right parietal and occipital cortex swelling with abnormal signals, expansion of supratentorial ventricular system, and degeneration of brain white matter (comparison of MRI is shown in Figure 2). MRI showed that the right parietal and occipital cortex swelling with abnormal signals disappeared (comparison of MRI is shown in Figure 2).
case_images: Maximum Intensity Projection sequence of MRA scan after neurological symptoms. MRA scan showed distal internal carotid artery occlusion, bilateral anterior and middle cerebral arteries occlusion, abundant and disordered collateral circulation at the circle of basal artery and bilateral basal ganglia, considered moyamoya disease.
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case_images: F3
case_images: Cranial MRA showed distal internal carotid artery occlusion, bilateral anterior and middle cerebral arteries occlusion, abundant and disordered collateral circulation at the circle of the basal artery and bilateral basal ganglia, all of which were classified as moyamoya disease (Figure 3).