title: Emergency microsurgical embolectomy in acute ischemic stroke with diffusion-negative MRI.
abstract: Although diffusion-weighted imaging (DWI) is highly sensitive and specific for the detection of acute ischemic injury, there are increasing reports that it may fail to demonstrate an acute stroke. Here, we present a case involving an acute ischemic stroke with a false-negative DWI in a 64-year-old woman who had undergone an emergency microsurgical embolectomy for an occluded middle cerebral artery (MCA). Although the endovascular mechanical embolectomy failed in treating the occluded MCA, we were able to successfully treat our patient with the second treatment option of a microsurgical embolectomy. Microsurgical embolectomy might be the treatment of choice, especially if the mechanical catheter is expected to not be able to access the target artery due to tortuous vascular structures.
authors.affiliation: Department of Neurosurgery, Wonkwang University School of Medicine, Iksan, Republic of Korea. Electronic address: kseom@wonkwang.ac.kr.
authors.forename: Ki Seong
authors.initials: KS
authors.lastname: Eom
authors.affiliation: Department of Neurosurgery, Wonkwang University School of Medicine, Iksan, Republic of Korea. Electronic address: kimdw@wonkwang.ac.kr.
authors.forename: Daw Won
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Wonkwang University School of Medicine, Iksan, Republic of Korea. Electronic address: kangsd@wonkwang.ac.kr.
authors.forename: Sungdon
authors.initials: S
authors.lastname: Kang
mesh_terms: D002545:Brain Ischemia / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging; D017128:Embolectomy / Q000379:methods*; D004638:Emergency Treatment; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000601:surgery*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D020521:Stroke / Q000175:diagnosis*
keywords: Acute ischemic injury; Diffusion-weighted imaging; Microsurgical embolectomy