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. 2020 Dec 1;94(1117):20200812. doi: 10.1259/bjr.20200812

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© 2020 The Authors. Published by the British Institute of Radiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

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Figure 3. — A 47-year-old male who was a chronic smoker, and had DM, HTN presented to the ED, with history of two episodes of weakness of the left side of the body that lasted for 1 h and totally resolved. He had fever and mild respiratory symptoms and tested positive for COVID-19. Axial MRI brain images at supraventricular level, (a) DWI b 1000, (b) T2-FLAIR and (c) T₁WI post i.v. contrast show precentral tiny lacunar diffusion restriction with bright signal on DWI-b 1000 (arrow in a), pre- and post-central cortical and subcortical areas of bright signal on FLAIR T₂WI, and gyral post-contrast enhancement (arrows in b, c respectively) consistent with acute to evolving subacute ischemic changes. This correlates with the resolved episodes of TIAs. (d) Intracranial MIP- 3D-MRA shows significant narrowing with mural irregularity of cavernous segment of right ICA (arrow in d) which probably along with COVID-19 increased thrombogenicity led to more distal small vessel emboli. DM, diabetes mellitus; ED,emergency department; FLAIR, fluid attenuated inversion recovery; HTN, hypertension;ICA, internal carotid artery; MIP, maximum intensity projection; MRA, MRangiography; TIA, transient ischemic attack.