Localized proton NMR spectroscopy at 1.5 T using stimulated echoes has been applied to study metabolic alterations in the postischemic phase of patients with acute cerebral infarction. A complete depletion of N-acetyl aspartate in the area of infarction has been observed in a patient studied 4 days after stroke. This finding was paralleled by a dramatic increase in the concentration of lactic acid to about 16 mM within the lesion, indicating continued anaerobic glycolysis. The diluting effect of the edema has been estimated to reduce average metabolite concentrations by about a factor of 3.