A 74-year-old man who presented to the emergency department after a fall with left-sided weakness. A 74-year-old man who presented to the emergency department.

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Presentation transcript:

A 74-year-old man who presented to the emergency department after a fall with left-sided weakness. A 74-year-old man who presented to the emergency department after a fall with left-sided weakness. Initial CT findings were normal (not shown). A, DWI sequence obtained 2 days later demonstrated an acute/subacute right frontal infarct. B, Several hours later, the patient had new contralateral symptoms, which prompted this CTP study. NCCT at that time demonstrated the right frontal opercular infarct. C−E, CT perfusion demonstrates asymmetric perfusion with relatively increased CBV (C), increased CBF (D), and decreased MTT (E) in this region (arrows) compared with the contralateral brain. This is consistent with postischemic hyperperfusion. Of note, no abnormalities are seen in the left hemisphere. F, The following day, the patient's symptoms progressed, and follow-up NCCT shows hemorrhage in the region of subacute infarction. Y.W. Lui et al. AJNR Am J Neuroradiol 2010;31:1552-1563 ©2010 by American Society of Neuroradiology