Acute ischemic stroke lasting for 5 days without definite lesions on diffusion-weighted magnetic resonance imaging in a patient with severe leukoaraiosis.
The reported frequency of false-negative diffusion-weighted magnetic resonance imaging (DWI) cases is 3.5%-25%. However, territorial stroke (eg, middle cerebral artery territory) with negative DWI is very rare. We report a case of territorial ischemic stroke persisting for 5 days without identification of a definite lesion on DWI but with decreased perfusion on perfusion computed tomography in a patient with underlying severe leukoaraiosis. This case suggests that severe leukoaraiosis might be responsible for the negative finding on DWI in acute ischemic stroke.
Han
Soo Jeong
SJ
Department of Neurology, The Catholic University of Korea, St. Mary's Hospital, Seoul, Korea.
Kim
Beum Saeng
BS
Shon
Young Min
YM
Cho
A-Hyun
AH
D002545:Brain Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D002533:Cerebral Angiography / Q000379:methods; D002560:Cerebrovascular Circulation; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D049292:Leukoaraiosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D055420:Perfusion Imaging / Q000379:methods; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed