1. Three perfusion sections.
Three perfusion sections. Occlusion of a left MCA branch and of the ipsilateral ICA. This 62-year-old man was admitted with right hemiparesis and aphasia 8 hours after the onset of symptoms. The color-coding is similar to that used in figure 1. A, Early conventional CT scans appear normal, although retrospectively, a discrete hypodense area can be seen in the cortex (A2).B, CBF maps show severe flow reduction in the fronto-opercular territory of the left MCA.C, CBV maps show the ischemic region to be less pronounced and indicate a 10% increase in blood volume in the surrounding cortex, which compensated for the reduced flow velocity in the territory of the left carotid artery.D, TTP concentration of contrast enhancement maps show time delay not only in the ischemic zone but also in the territories of the entire left MCA and anterior cerebral artery due to occlusion of the ICA, as revealed by sonography. Acute left carotid artery occlusion might have led to embolization in a frontal branch of the MCA.E, Follow-up CT scans, obtained 3 days after stroke, show a small infarct representing the former ischemic area of the frontal cortical territory of the MCA (red arrowheads).
Thomas E. Mayer et al. AJNR Am J Neuroradiol 2000;21:
©2000 by American Society of Neuroradiology