Diffusion-negative MRI in acute ischemic stroke: a case report

Diffusion-weighted magnetic resonance imagingis a very sensitive tool for the early diagnosis of acute ischemic stroke. This is employed in some stroke centers as the primary screening tool to select patients eligible for thrombolysis.

Methods: We present the case of a 49-years old Chinese man whose diffusion-weighted magnetic resonance imaging performed 12 hours of symptom onset was negative.

Results: Although the initial diffusion-weighted magnetic resonance imaging was negative, the imaging repeated after 4 days despite static neurological symptoms and signs, could demonstrate an acute medullary infarction.

Conclusions: Diffusion-weighted imaging may not be100% sensitive in very early stages, especially in posterior circulation strokes. Our case serves as a reminder that clinical assessment still retains priority until a diagnostic modality offering 100% sensitivity and specificity is discovered.

Author: Rahul Rathakrishnan, Vijay K Sharma and Bernard PL Chan
Credits/Source: Cases Journal 2008, 1:65

Published on: 2008-07-29

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