CASE HISTORY/CLINIC:
58-year-old male with diagnosed stenosis of the right carotid artery.



FINDINGS:

Evidence of a hyperintense area in the right frontal supply region of the anterior cerebral artery on T2-w, FLAIR and DWI. Area appears hypointense on ADC, iso- to hypointense on pre-contrast T1 and shows no enhancement on postcontrast image (not shown).
A area can also be seen on the right parietal lobe, that appears isohypertense on T-2w, Flair, DWI and ADC and enhances on T1-w, unlike in the non-contrast image.


DIAGNOSIS:
Fresh infarction of the anterior cerebral artery located on the right side of the frontal lobe and a little older partial infarction of the middle cerebral artery with right-sided parietal luxury perfusion caused by a „spreading“ stenosis of the right carotid artery.