Fig. 2

The changes of cerebral blood flow. a. Left cerebral perfusion is lower than right cerebral perfusion on preoperative magnetic resonance imaging 3D–arterial spin labeling (MRI 3D-ASL). b. T2-weighted magnetic resonance imaging showed mild focal cerebral edema in the operative area and a swollen temporal muscle on the 3rd day after surgery (The black arrow indicates cerebral edema at the sites of anastomosis). c. MRI 3D-ASL showed increased cerebral blood flow (CBF) at the sites of anastomosis with mildly increased CBF of the adjacent cerebral cortex on the 3rd day after surgery (The black arrow indicates increased CBF at the sites of anastomosis). d. MRI 3D-ASL shows high CBFs in the region distributed by dual recipient vessels compared with the adjacent cerebral cortex, while cerebral perfusion of the whole brain displays a relative low level on the 21st day after surgery (The black arrow indicates high CBFs, and the red circle indicates the region of interest of the middle cerebral artery (MCA) distribution). e. MRI 3D-ASL examined at 6 months after surgery shows good improvement on the left side and a normal level on the right side