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Case - ASL Matched Defect

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These are images of an 83-year-old

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male with confusion, neglect,

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and some left-sided weakness.

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And you can see on the DWI, he's got an

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large infarct involving the left posterior

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insula, the right temporal lobe,

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and extending up into the inferior parietal lobe.

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And when we inspect the ASL images,

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you can see the defects matched

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between the ASL and DWI images.

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So, it's an MCA inferior division infarct.

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It's a completed infarct.

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The infarct shouldn't extend.

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Here are the FLAIR images.

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You can see on the FLAIR images,

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there's some effacement of sulci and a little mass

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effect on the atrium and lateral ventricles.

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It's already in the subacute stage, continues

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to be dark on ADC maps as you'd expect.

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And then, just so you can see the vessels.

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Here are the vessels,

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there's an inferior division MCA cutoff,

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the superior division's intact.

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So, this is an example of a matched defect

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on ASL where you don't need aggressive

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treatment because there's not tissue at risk.

Report

Faculty

Pamela W Schaefer, MD, FACR

Professor of Radiology, Vice Chair of Education

Massachusetts General Hospital

Tags

Vascular Imaging

Neuroradiology

Neuro

MRI

Head and Neck

Brain

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