Extensive bihemispheric ischemia caused by acute occlusion of three major arteries to the brain.

An 86-year-old woman developed cardioembolic stroke three times. In the last one, she fell into sudden coma and fatal outcome due to acute occlusion of bilateral internal carotid arteries (ICAs) and the basilar artery. Diffusion-weighted magnetic resonance imaging (MRI) delineated brain ischemia in the whole bilateral cerebral hemisphere soon after the stroke onset. Signal intensity of the brain parenchyma increased in whole the hemisphere. Especially, all the cortical rims glittered. This is the first report of the cardioembolic stroke due to simultaneous occlusion of the three major arteries to the brain.