Bilateral acute ischemia in the motor cortex area. (A) Spinal cord magnetic resonance imaging (MRI) was normal and showed no signs of compression or ischemia. Of note, acute infarction, for example of the anterior spinal artery may be undetected in early spinal MRI. (B and C) Diffusion (B) and apparent diffusion coefficient-weighted (C) brain MRI revealed acute infarctions in the precentral gyrus on both sides (medial and parietal parts). (D) At the level of the internal capsule no pathological diffusion restrictions were found. (E) In contrast to diffusion, T2-weighted images did not show any signs of tissue demarcation confirming the acuteness of stroke onset.