FLAIR vascular hyperintensity resolution in a TIA patient

An 83-year-old woman presented with acute aphasia. Brain MRI, performed 3 hours after symptom onset, showed isolated fluid-attenuated inversion recovery vascular hyperintensities (FVH) in the left middle cerebral artery, including dot-like and serpentine hyperintensities (figure). Immediately after this first MRI (i.e., 3 hours and 15 minutes after symptom onset), aphasia resolved. A second MRI performed 15 minutes later showed FVH disappearance.