Hyperintense vessel (HV)s on fluid-attenuated inversion recovery (FLAIR) in acute ischemic stroke
are thought to represent slow antegrade or retrograde leptomeningeal collateral flow. A 33-year-old
female patient with aphasia showed acute infarction in the left middle cerebral artery territory with
stenosis on brain magnetic resonance imaging (MRI). HVs on FLAIR were seen in middle cerebral artery territory. One year follow up MRI showed near occlusion of left middle cerebral artery and disappearance
of FLAIR HVs. FLAIR HVs are dynamic imaging sign which correlates with the corresponding arterial flow status.