Occlusive vessel signs on MRI as only findings of hyperacute ischemic stroke

A 64-year-old woman presented with a partial seizure on the left side of her face. Although diffusion weighted images and magnetic resonance angiography 3 h after the onset did not show any signs of ischemic stroke, a susceptibility vessel sign (SVS) on T2*-weighted gradient echo imaging (GRE) and a hyperintense vessel sign (HVS) on fluid attenuated inversion recovery images at the distal branch of the right middle cerebral artery were revealed. One day later, these GRE SVS and HVS signs disappeared and a new infarct lesion in the right insular cortex was found on magnetic resonance images (MRI). It is suggested that occlusive vessel signs on MRI, including GRE SVS and HVS, are sometimes the only findings of ischemic stroke at the hyperacute phase.