Figure 1: (a) Apparent diffusion coefficient (ADC)-map at the initial admission shows lacunar infarction in the subcortical white matter of the putamen and adjacent parts of the left internal capsule (arrow). The low signal on ADC indicates restricted diffusion seen in acute ischemic injury. (b-c) CTangiography (CTA) showed normal MCAs (arrows heads)(d-e) FLAIR axial image and ADC-map at the second admission upon development of left leg weakness shows new acute infarction in the left ACA (arrows). (f) MR-angiography shows extensive fragmental and irregular flow signal in MCA-M1 segment bilaterally (arrow heads) as well in the left ACA. (g) FLAIR axial image at a later occasion shows new infarctions in right ACA-territory (white arrows) and in the left MCA (black arrow). (h-i) FLAIR axial image and ADC map at the final stage of the disease shows extensive bihemispheric infarctions in both ACA and MCA-territories