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Stroke with negative brain magnetic resonance imaging
M J Alberts1, M E Faulstich, L Gray
1Division of Neurology, Duke University Medical Center, Durham, N.C. 27710.
Stroke
|May 1, 1992
Summary
Magnetic resonance imaging (MRI) may not detect all acute ischemic strokes, even when performed within 24 hours of symptom onset. This study highlights potential limitations of MRI in diagnosing certain stroke types.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Brain magnetic resonance imaging (MRI) is increasingly used for diagnosing acute ischemic strokes.
- Previous studies indicated potential limitations of MRI in detecting all acute strokes.
- Clinical details of strokes missed by MRI were previously scarce.
Observation:
- Seven patients with clinically diagnosed ischemic stroke and negative brain MRI scans were identified.
- Six patients were scanned within seven days of symptom onset; two were scanned within 24 hours.
- Strokes were localized to the cortex, brain stem, and subcortical/lacunar areas.
Findings:
- Despite advanced imaging techniques, MRI may fail to detect acute ischemic strokes.
- Negative MRI scans can occur even with prompt imaging (within 24 hours).
- Specific stroke locations (cortex, brain stem, subcortical) were associated with missed diagnoses.
Implications:
- Clinicians should consider potential MRI limitations in acute stroke diagnosis.
- Negative MRI results do not definitively exclude stroke, especially in specific locations.
- Further research is needed to improve MRI sensitivity for all stroke types.
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