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Brain microembolism.

Ahmed Aly1, Viken L Babikian, Glenn Barest

  • 1Department of Neurology, Department of Radiology, Boston University School of Medicine, Harvard Medical School, MA, USA.

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|May 2, 2003
PubMed
Summary
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Clinicians should be aware of atypical brain infarction presentations. Magnetic resonance diffusion-weighted imaging (DWI) effectively detects these small, multiple acute infarcts, often linked to microembolism.

Area of Science:

  • Neurology
  • Neuroimaging
  • Stroke Medicine

Background:

  • Brain infarction subtypes require precise diagnostic approaches.
  • Early detection of acute ischemic events is crucial for patient outcomes.

Observation:

  • Five patients presented with atypical symptoms suggestive of brain ischemia.
  • Computed tomography (CT) scans were insufficient for diagnosing these acute infarcts.

Findings:

  • Diffusion-weighted imaging (DWI) identified 3 to over 20 small, recent brain infarcts per patient.
  • Magnetic resonance imaging (MRI) fluid-attenuated inversion recovery (FLAIR) sequences showed most lesions.
  • DWI was essential for determining the acuity of the infarcts, with suspected microembolism as the etiology.

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Implications:

  • This subtype of brain infarction may present with subtle or atypical clinical signs.
  • Advanced MRI techniques, particularly DWI, are vital for accurate diagnosis and characterization.
  • Recognizing these findings aids in identifying potential embolic sources and guiding treatment.