Purpose. To demonstrate the possibilities of the magnetic resonance technique of arterial spin labeling in the diagnostic algorithm of chronic cerebrovascular accident.

Materials and methods. A 63-year-old patient was examined on an outpatient basis with a diagnosis of "Chronic cerebrovascular accident". Complaints, anamnesis, physical, neurological and psychocognitive statuses were evaluated at the initial admission and after 3 months of therapy. Laboratory methods of investigation, ultrasound examination of brachiocephalic arteries, magnetic resonance imaging of the brain using technique of arterial spin labeling, as well as magnetic resonance imaging in dynamics after therapy were performed.

Results. Primary arterial spin labeling showed a decrease in perfusion in functionally active centers. After the therapy, according to arterial spin labeling data, an increase in blood flow in the studied areas was noted in dynamics.

Discussion. The pathogenesis of сhronic cerebrovascular accident with the development of endothelial dysfunction and, as a consequence, capillary stasis explains the changes in cerebral blood flow detected by the arterial spin labeling method. Regular cognitive-behavioral training causes a steady local increase in blood flow, thereby indicating the effectiveness of the therapy, which is objectively confirmed not only by the cognitive status of the patient, but also with the help of arterial spin labeling.