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Acute Stroke Syndrome With Fixed Neurological Deficit and False‐Negative Diffusion‐Weighted Imaging
Author(s) -
Wang Wei,
Goldstein Steven,
Scheuer Mark L.,
Branstetter Barton F.
Publication year - 2003
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2003.tb00174.x
Subject(s) - medicine , neurological deficit , magnetic resonance imaging , stroke (engine) , hemiparesis , aphasia , cerebral stroke , diffusion mri , ischemia , middle cerebral artery , cardiology , radiology , anesthesia , psychiatry , angiography , mechanical engineering , engineering
Diffusion‐weighted imaging (DWI) is sensitive for the detection of acute ischemic stroke. However, a negative DWI study of the brain does not always exclude a patient from the possibility of acute cerebral ischemia. The authors report 1 case in which the patient presented with a fixed ischemic neurological deficit (National Institute of Health Stroke Scale score = 22) that included global aphasia, right hemiparesis, and a right visual field neglect. The initial DWI of the brain within 27 hours of symptom onset was negative. The deficit persisted, and a repeat magnetic resonance imaging study 7 days later showed a large area of restricted diffusion involving the gray matter of the entire left middle cerebral artery and anterior cerebral artery distribution, indicating a large area of cortical stroke.