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Resolution of early diffusion-weighted and FLAIR MRI abnormalities in a patient with TIA
F E Lecouvet1, T P Duprez, J M Raymackers
1Department of Neuroradiology, Saint Luc University Hospital, University of Louvain, Brussels, Belgium.
Abstract:
We report a patient with a clinical history and neurologic examination consistent with acute stroke. Diffusion-weighted and fast fluid-attenuated inversion recovery MRI obtained 4 hours after stroke onset detected focal abnormalities suggestive of acute ischemic brain damage. The neurologic deficit and the imaging abnormalities both resolved completely at follow-up. This patient illustrates complete resolution of early changes observed with diffusion-weighted MRI at the hyperacute phase in a TIA.
Insights
Transient ischemic attack (TIA) patients can experience complete resolution of acute stroke imaging changes. Diffusion-weighted MRI may show temporary abnormalities that fully resolve, indicating a TIA rather than a persistent stroke.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Acute stroke diagnosis relies on clinical presentation and neuroimaging.
- Diffusion-weighted MRI (DW-MRI) is sensitive to early ischemic changes.
- Transient Ischemic Attack (TIA) is a critical warning sign for future stroke.
Observation:
- A patient presented with symptoms and examination findings indicative of acute stroke.
- Neuroimaging, including DW-MRI and FLAIR, revealed focal abnormalities consistent with acute ischemic brain damage within 4 hours of symptom onset.
- The patient's neurological deficits and the observed MRI abnormalities showed complete resolution upon follow-up.
Findings:
- The case demonstrates the complete resolution of hyperacute changes seen on DW-MRI.
- This complete resolution of imaging abnormalities supports a diagnosis of TIA.
- The findings highlight the dynamic nature of early ischemic changes in TIA.
Implications:
- Complete resolution of early DW-MRI findings in the hyperacute phase can signify a TIA.
- This case underscores the importance of follow-up imaging and clinical assessment in differentiating TIA from stroke.
- Understanding these imaging dynamics is crucial for accurate diagnosis and risk stratification of cerebrovascular events.