case_images: PMC8224401_01
case_images: PMC8224401_02
case_images: MPS I prior to stroke. (Left) MRI Head demonstrating imaging findings of macrocephaly, ventriculomegaly, small foramen magnum, and mild narrowing of cervical spine without cord compression. (Right) CT Head with contrast demonstrating bilateral internal carotid termini without stenosis.
case_images: fped-09-606905-g0001.jpg
case_images: PMC8224401_02_fped-09-606905-g0001.jpg
case_images: F1
case_images: HSCT, neuroimaging was obtained for macrocephaly and findings were consistent with MPS I (Figure 1). However, the patient showed no clinical evidence of neurological symptoms at this time.
case_images: PMC8224401_03
case_images: MPS I arteriopathy after left cerebral stroke. (Left) MR angiogram 8 weeks after stroke with left MCA occlusion and bilateral ICA termini steno-occlusive disease. (Right) New left arm weakness episodes 3 months after overt stroke with persisting bilateral steno-occlusive disease and adjacent irregular collaterals identified on CT angiogram (yellow arrow).
case_images: fped-09-606905-g0002.jpg
case_images: PMC8224401_03_fped-09-606905-g0002.jpg
case_images: F2
case_images: MRI revealed an acute left middle cerebral artery (MCA) territory infarct and right cerebral ischemia. MR and CT angiography demonstrated complete absence of blood flow into the distal left MCA segments and bilateral carotid terminus narrowing (Figure 2).
case_images: PMC8224401_04
case_images: (Upper) Initial MRI of left MCA overt stroke identified on T2, diffusion, and MRA. (Lower) Two years after right cerebral revascularization demonstrating no new ischemic or infarcted territories and increased right cerebral cortical vascularity.
case_images: fped-09-606905-g0003.jpg
case_images: PMC8224401_05_fped-09-606905-g0003.jpg
case_images: F3
case_images: A 2-year postoperative MRI demonstrated increased cortical vascularity without progressive ischemic changes (Figure 3, Lower panel).
case_images: PMC8224401_05
case_images: (Upper) Initial MRI of left MCA overt stroke identified on T2, diffusion, and MRA. (Lower) Two years after right cerebral revascularization demonstrating no new ischemic or infarcted territories and increased right cerebral cortical vascularity.
case_images: fped-09-606905-g0003.jpg
case_images: PMC8224401_05_fped-09-606905-g0003.jpg
case_images: F3
case_images: A 2-year postoperative MRI demonstrated increased cortical vascularity without progressive ischemic changes (Figure 3, Lower panel).