Brain microembolism.
OBJECTIVE
To alert clinicians about the occurrence of a subtype of brain infarction, its suspected etiology, and its detection by specific neuroimaging techniques.


METHODS
The article presents 5 nonconsecutive patients admitted to the stroke services of 2 tertiary care hospitals, who presented with acute or subacute symptoms suspicious, but at times atypical, of brain ischemia.


RESULTS
Each patient had evidence of 3 to > 20 small areas of recent brain infarction detected by diffusion-weighted imaging (DWI). When available, brain computerized tomography images were not helpful for the diagnosis of these recent infarcts. Most lesions were present on magnetic resonance imaging fluid-attenuated inversion recovery sequences, but the diffusion-weighted images allowed the determination of their acuity. Further evaluation revealed a potential source of embolism in each patient. Brain microembolism was suspected in all cases.


CONCLUSIONS
Small and multiple areas of acute or subacute brain infarction occasionally present with clinical features atypical for brain embolism. They can be detected by magnetic resonance DWI studies.
Department of Neurology, Department of Radiology, Boston University School of Medicine, Harvard Medical School, MA, USA.
Ahmed
A
Aly
Viken L
VL
Babikian
Glenn
G
Barest
Mihran
M
Artinian
Alejandro
A
Forteza
Carlos S
CS
Kase
D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged