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FIG 2. 3-year-old boy with an initial manifestation of transient bilateral motor weakness followed by left hemiparesis and mild right hemiparesis.
A, Anteroposterior view of a right carotid angiogram shows stenoocclusive changes at the terminal part of the ICA and the proximal part of the ACA and MCA. Well-developed moyamoya vessels around the terminal part of the ICA and a partial disappearance of cortical branches of the ACA and MCA are also evident (ICA stage III).
B, The right PCA is also opacified on lateral view of right carotid angiogram. The right PCA shows mild stenosis in its ambient segment (arrow) with delayed opacification of the right parietooccipital artery (arrowhead) (PCA stage 2). Leptomeningeal collaterals were poor at a later phase (not shown). Vertebral angiography did not fill the right PCA, and the left PCA showed no stenoocclusive changes (PCA stage 1) (not shown). A left carotid angiogram showed ICA stage II (not shown).
C, Axial T2-weighted (2500/90/1) MR image shows infarction in the right frontal (ant-MCA) (arrow) and parietal regions (post-MCA).
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