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Related Experiment Videos

Diffusion-negative stroke: a report of two cases.

P Y Wang1, P B Barker, R J Wityk

  • 1Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

AJNR. American Journal of Neuroradiology
|December 10, 1999
PubMed
Summary
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Diffusion-weighted imaging (DWI) is crucial for acute stroke diagnosis. However, these two hyperacute stroke cases show DWI may appear normal within 4 hours, highlighting the need for careful clinical correlation.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Diffusion-weighted MR imaging (DWI) is a cornerstone for detecting acute ischemic stroke.
  • Its high sensitivity is generally accepted for early stroke diagnosis.

Observation:

  • Two cases of hyperacute stroke presented with normal DWI findings within 4 hours of symptom onset.
  • Initial perfusion imaging in one case revealed deficits not yet visible on DWI.

Findings:

  • Absence of signal changes on DWI does not exclude early-stage cerebral infarction.
  • Follow-up MRI 4 days later confirmed infarction in both cases.

Implications:

  • Clinicians should consider potential infarction even with normal DWI in hyperacute stroke scenarios.

Related Experiment Videos

  • DWI findings should be interpreted alongside clinical presentation and perfusion data.
  • This challenges the universal assumption of DWI's immediate sensitivity in all acute stroke presentations.