On admission, his pulmonary, heart, and abdominal physical examination was normal except for varicose veins of the lower extremities and mild scoliosis in thoracic segments. He had normal BMI. Neurologic examination revealed that he had motor aphasia, memory deficiency, dysesthesia, and weakness of the right face and extremities. The biochemistry tests of liver and kidney, lipid profile, and blood gas test were within the normal range. Plasma angiotensin-converting enzyme was 14 U/L (normal range: 18-55 U/L). EEG was normal. Brain MRI was repeated, and diffusion weight imaging showed multiple recent infarctions in the frontal lobe, occipital lobe, insular lobe, and head of the caudate nucleus, as well as multiple old infarctions in the right thalamus and bilateral cerebella.