Value of diffusion-weighted imaging in patients with a nonlocalizing examination and vasospasm from subarachnoid...

We evaluated the value of diffusion-weighted imaging (DWI) in patients with suspected vasospasm from subarachnoid hemorrhage (SAH). Magnetic resonance imaging (MRI), including DWI, was performed in 5 patients with vasospasm resulting from SAH. Restricted diffusion (ischemia) was present in 3 patients with symptomatic vasospasm. A diffusion abnormality was not demonstrated in 2 patients with asymptomatic vasospasm despite persistently elevated velocities by transcranial Doppler ultrasonography in 1. In this patient, serial MRI studies showed no ischemia. Our results suggest that DWI may provide a method to assess the presence and severity of ischemia in patients with SAH and vasospasm and assist in patient management.