Interpretation of infarct location in relationship to perfusion territories using territorial arterial spin labeling in a patient with multiple infarctions: A case report

We, herein, describe a 50-year-old man with steno-occlusive cerebrovascular disease and multiple infarcts that were expected to be within the perfusion territories of the basilar artery (BA) and left internal carotid artery. However, territorial arterial spin labeling (T-ASL) perfusion magnetic resonance imaging showed that the infarct lesions were only located in the perfusion territory of the BA and confirmed the stroke etiology of large artery atherosclerosis. This case implies that the diagnostic information provided by T-ASL is valuable for identifying the symptomatic perfusion territories and stroke etiology. This technique is, therefore, able to guide therapeutic management in patients with multiple infarcts.