case_images: PMC7989788_01
case_images: a CT without contrast showing substance loss in the left frontal operculum due to a previous ischemic infarct (red arrow) with no visible infarct in the right opercular region (white arrow). b CT mean transit time showing elevated transit time in the right opercular region (white arrow) and in the left opercular region of the old infarction (red arrow). c CT cerebral blood flow (CBF) showing decreased cerebral flow in the right opercular region (white arrow), and in the left opercular region of the old infarction (red arrow). d CT CBF with slightly increased cerebral blood volume in the right frontal operculum (white arrow) compared to the left opercular region of the old infarction (red arrow).
case_images: crn-0013-0166-g01.jpg
case_images: PMC7989788_01_crn-0013-0166-g01.jpg
case_images: F1
case_images: On admission, the initial computed tomography (CT) scan of the brain showed substance loss from an old infarction in the left frontal operculum (Fig. 1a). CT angiography was normal, but the CT perfusion scan showed increased mean transit time with corresponding reduced cerebral blood flow and slightly increased cerebral blood volume in the right frontal operculum, indicating a penumbra region (Fig. 1b-d).