Diffusion-negative stroke: a report of two cases.
Diffusion-weighted MR imaging is generally thought to be highly sensitive for the diagnosis of acute stroke. We report two cases of hyperacute stroke with absence of changes on diffusion-weighted images within 4 hours of symptom onset. Follow-up studies, performed 4 days later, showed infarction in regions compatible with the clinical presentation and (in one case) with the initial perfusion deficit. These cases indicate that normal findings on diffusion-weighted images in patients with suspected cerebral ischemia do not rule out impending infarction.
Wang
P Y
PY
Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Barker
P B
PB
Wityk
R J
RJ
Uluğ
A M
AM
van Zijl
P C
PC
Beauchamp
N J
NJ
D000208:Acute Disease; D000368:Aged; D002544:Cerebral Infarction / Q000175:diagnosis*; D003937:Diagnosis, Differential; D017352:Echo-Planar Imaging; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D012680:Sensitivity and Specificity