Parametric images of a patient with stage 2 haemodynamic failure. This 69-year-old man presented with a minor ischaemic stroke (without infarction on his MRI) and recurrent TIAs from the left hemisphere associated with a left ICA occlusion. The baseline PET study showed decreased cerebral blood flow (CBF) and increased oxygen extraction fraction (OEF) in the territories of both anterior and middle cerebral artery of the left hemisphere. This patient was randomised for tapering of antihypertensive medication. The PET study after 3 months showed a slight improvement in CBF and OEF. However, he still had recurrent TIAs in the presence of stage 2 haemodynamic failure.