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Updated: Sep 10, 2026

A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Hyperacute ischemic stroke missed by diffusion-weighted imaging
D Lefkowitz1, M LaBenz, S R Nudo
1Department of Diagnostic Radiology, University of Maryland Medical System, Baltimore, MD 21201-1595, USA.
Abstract:
We present two cases of hyperacute ischemic stroke that were initially missed by diffusion-weighted imaging; abnormalities in locations corresponding to focal neurologic deficits were discovered by MR angiography and perfusion-weighted imaging. Within hours, follow-up diffusion-weighted scans revealed partial conversion of the hypoperfused regions to complete stroke. These cases illustrate the potential for a nonresolving stroke-in-evolution to go undetected by diffusion-weighted imaging at hyperacute timepoints.
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