Fig. 11. Middle cerebral artery infarct in a 4-day-old male with history of prolonged delivery with nuchal cord presenting with seizures.

Axial T2 (a), T1(b) and diffusion MR (c) images demonstrate an extensive region of hypointense T1 and hyperintense T2 signal involving right cerebral hemisphere in the distribution of the middle cerebral artery, with effacement of the sulci and right lateral ventricle, with corresponding restricted diffusion, consistent with right MCA distribution subacute ischemic infarct. Restricted diffusion also extends into the right thalamus, basal ganglia, cerebral peduncle and across the splenium of the corpus callosum. Axial MIP image (d) from a 2 D time-of-flight MR angiogram of the head without contrast shows normal intracranial arteries with no evidence of decreased or absent flow in the right MCA