case_images: PMC8405213_01
case_images: MRI. Axial T2 FLAIR weighted images (A, B). T1-weighted axial images without venous contrast (C) and arterial 3D TOF MRA (D). We noticed hypersignal on T2/FLAIR at the right frontoparietal lobes , with spinning thickening and mild vasogenic edema, corresponding to ischemic arterial vascular injury. There is also cortical spontaneous hypersignal on T1, without expression on T2* images, related to cortical laminar necrosis. There is no mass or reduction on the ADC map on these changes (not shown). We noticed slight signal loss in the proximal segment (M1) of the right middle cerebral artery, in addition to clear asymmetry of its distal segments (M3), with mild vascular poverty to the right (D). MRI, magnetic resonance imaging; FLAIR, fluid-attenuated inversion recovery; MRA, magnetic resonance angiography; 3D TOF, three-dimensional time of flight;
  ADC, apparent diffusion coefficient
case_images: 1678-9849-rsbmt-54-e0301-2021-gf1.jpg
case_images: PMC8405213_01_1678-9849-rsbmt-54-e0301-2021-gf1.jpg
case_images: f1
case_images: Magnetic resonance imaging of the brain showed signal hyperintensity on T2 FLAIR at the right frontoparietal lobes, related to ischemic arterial vascular event (Figure 1. A-C); while the magnetic resonance angiography (MRA) without venous contrast revealed asymmetry of the middle cerebral arteries, with subtle changes to the right (Figure 1.
case_images: MRI. T1-weighted axial images (A) and T2*-weighted axial images (B and C). A posterior rounded lesion in in the cingulate gyrus, with spontaneous hypersignal on T1 (A) and hyper with hypointense halo on T2* (B), related to parenchymal hematoma. Control examination shows hematoma in the chronic stage, with reduction in size and marked hypointensity on T2* related to hemosiderin (C). MRI: Magnetic resonance imaging; FLAIR: fluid-attenuated inversion recovery
case_images: 1678-9849-rsbmt-54-e0301-2021-gf2.jpg
case_images: PMC8405213_01_1678-9849-rsbmt-54-e0301-2021-gf2.jpg
case_images: f2
case_images: Additionally, we noticed a posterior rounded lesion in the cingulate gyrus, with spontaneous hypersignal on T1 (Figure 2. A) and hypersignal with a hypointense halo on T2* (Figure 2. B), which was related to a parenchymal hematoma (Figure 2.