FIG 2. Case 2: 65 year-old man with mild to moderate aphasia, a slight left-sided facial droop, and minimal left pronator drift scanned 3.5 hours (top row), 13 hours (middle row), and 4 days (bottom row) after symptom onset.

Top row, Initial T2-weighted (T2W), diffusion-weighted (Isotropic DWI), and D_av images were normal, but the perfusion MR image revealed a large area of delayed flow in the right MCA territory.

Middle row, At 13 hours, the T2-weighted image remained normal but diffusion-weighted hyperintensity and reduced D_av are now apparent in the right MCA territory.

Bottom row, T2-weighted image at 4 days revealed hemorrhagic infarction with edema and mild mass effect. The infarct showed decreased D_av at this time, while the perilesional edema had increased D_av.