Fig. 2.

A case of converging pathways: atherosclerosis and CSVD in a senior patient. This figure presents MRI findings from a 77-year-old female with a history of hypertension, insulin-dependent diabetes mellitus, and Crohn’s disease, who exhibited symptoms of weakness and disorientation. CT angiography revealed severe stenosis of the proximal right middle cerebral artery (MCA) and its M2 branches (panel A, arrow), indicative of intracranial atherosclerosis. Concurrently, MRI FLAIR images showcased white matter hyperintensities (panel B, arrows), aligning with a diagnosis of moderate severity chronic CSVD, alongside an acute infarct in the right MCA watershed territory (not shown). This case vividly illustrates the interconnected nature of vascular pathologies, encapsulating the essence of accelerated vascular aging's impact on both large and small cerebral vessels