1. 67-old man with 45-min onset left hemiparesis Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology

2. Vignette 3.0-Tesla gadolinium-enhanced MRI (iodine contrast allergy) at admission: right frontoparietal small infarcts on diffusion-weighted images without vascular obstruction Complete spontaneous symptoms regression No reperfusion therapy was given Twenty-four hours later a second MRI and a CT were done © 2015 American Academy of Neurology Patroclo et al

3. Imaging © 2015 American Academy of Neurology Patroclo et al

4. Hyperintense Acute Reperfusion Marker (HARM) in Ischemic Stroke with Transient Symptoms HARM is an early and transient blood–brain barrier disruption sign caused by leakage of gadolinium-based contrast into the CSF Caution must be taken to avoid misinterpreting it as subarachnoid hemorrhage © 2015 American Academy of Neurology Patroclo et al