Hyperacute ischemic stroke missed by diffusion-weighted imaging.
We present two cases of hyperacute ischemic stroke that were initially missed by diffusion-weighted imaging; abnormalities in locations corresponding to focal neurologic deficits were discovered by MR angiography and perfusion-weighted imaging. Within hours, follow-up diffusion-weighted scans revealed partial conversion of the hypoperfused regions to complete stroke. These cases illustrate the potential for a nonresolving stroke-in-evolution to go undetected by diffusion-weighted imaging at hyperacute timepoints.
Lefkowitz
D
D
Department of Diagnostic Radiology, University of Maryland Medical System, Baltimore, MD 21201-1595, USA.
LaBenz
M
M
Nudo
S R
SR
Steg
R E
RE
Bertoni
J M
JM
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis*; D002343:Carotid Artery, Internal / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis; D002544:Cerebral Infarction / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004058:Diffusion; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging