case_images: PMC5831235_01
case_images: MRI brain reveals an area of diffusion restriction over the right MCA territory (orange arrow) with corresponding signal loss on Apparent Diffusion Coefficient (ADC) mapping (blue arrow), suggesting acute ischemic infarct.
case_images: CRINM2018-2410154.001.jpg
case_images: PMC5831235_01_CRINM2018-2410154.001.jpg
case_images: fig1
case_images: Magnetic resonance imaging (MRI) of the brain was performed while he was an inpatient, revealing a right MCA territory infarct (Figure 1).
case_images: CT angiogram of the circle of Willis showing multiple areas of luminal irregularity.
case_images: CRINM2018-2410154.002.jpg
case_images: PMC5831235_01_CRINM2018-2410154.002.jpg
case_images: fig2
case_images: As shown in Figure 2, there was bilateral moderate luminal irregularity in the M2 branches of the MCAs (more pronounced on the right, as shown by arrows) with less pronounced changes in the A2 segments of the anterior cerebral arteries and their branch vessels, raising suspicion for small to medium vessel vasculitis.