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A 71-year-old man with atrial fibrillation was presented to the emergency department 30 min after the sudden onset of disturbance of consciousness. On examination, he showed a disturbance of consciousness (Glasgow Coma Score: E4V2M5) and severe right hemiplegia, which subsequently improved, and he finally presented with moderate sensory aphasia alone. CT of the head showed no haemorrhage. Diffusion-weighted MRI (DW-MRI) of the brain showed a high-intensity spot lesion in the left insular cortex (figure 1A). Arterial spin-labelled (ASL) perfusion MRI showed hyperperfusion in the same …
Contributors YS was a major contributor in writing the manuscript. DY, TU also treated the patient and interpreted the patient data. All authors read and approved the final manuscript.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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