Figure 1 Head imaging findings on June 10 Axial DWI showed hyperintensity in the left temporal lobe, parietal lobe and insula (Panel 1a). MRA showed no significant stenosis or occlusion of intracranial large vessels (Panel 1b).

Figure 2 Head axial CT on June 10 showed hypointensity in left temporal lobe (arrow indicates).

Figure 3 Head axial CTP findings on June 10 The cerebral blood volume (CBV) increased in left frontal lobe (red areas indicate, Panel 3a). The cerebral blood flow (CBF) increased in left frontal lobe (red areas indicate, Panel 3b). The time to peak (TTP) of the left frontal lobe was shortened (blue areas indicate, Panel 3c). The mean transit time (MTT) of the left frontal lobe was shortened (blue areas indicate, Panel 3d). Figure 4 Head axial CT on June 14 showed new hypointensity in right temporo-parietal lobe (arrow indicates).

Figure 5 TCD foam test showed the "rain curtain" microbubble signals in the siphon section of both ICA Left ICA (Panel 5a). Right ICA (Panel 5b).

Figure 6 CTPA findings on June 16 Axial CTPA showed multiple clearly defined circular nodules in the left lower lung, which were significantly enhanced (Panel 6a, 6b). Coronal CTPA showed circular nodule enhanced vascular mass in the lower left lung (arrows indicate), a thickened vascular bundle was connected on the left as the input artery, and a small tortuous vascular shadow was seen on the right as the drainage vein (Panel 6c, 6d).

Figure 7 Head MRI findings on June 24 Axial T₁WI showed hypointensity in the right temporal lobe with surrounding edema (arrow indicates, Panel 7a). Axial T₂WI showed mixed hypointensity and hyperintensity in the right temporal lobe with surrounding edema (arrow indicates, Panel 7b). Axial FLAIR showed mixed hypointensity and hyperintensity in the right temporal lobe with surrounding edema (arrow indicates, Panel 7c). Axial SWI showed swelling of the right temporal lobe with multiple patchy hypointensity and surrounding edema (arrow indicates, Panel 7d).