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Related Concept Videos

Transient Ischemic Attack l: Introduction01:26

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Magnetic Resonance Imaging01:24

Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) is a noninvasive medical imaging technique based on a phenomenon of nuclear physics discovered in the 1930s, in which matter exposed to magnetic fields and radio waves was found to emit radio signals. In 1970, a physician and researcher named Raymond Damadian noticed that malignant (cancerous) tissue gave off different signals than normal body tissue. He applied for a patent for the first MRI scanning device in clinical use by the early 1980s. The early MRI...

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Related Experiment Video

Updated: Jul 5, 2026

Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
10:25

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Published on: September 25, 2019

When to expect negative diffusion-weighted images in stroke and transient ischemic attack.

P N Sylaja1, Shelagh B Coutts, Andrea Krol

  • 1Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Room 1162, University of Calgary, Alberta, Canada.

Stroke
|April 19, 2008
PubMed
Summary

A significant number of acute stroke and TIA patients initially show negative diffusion-weighted imaging (DWI). Follow-up MRI can confirm infarcts in a subset of these DWI-negative cases, particularly those with brainstem or lacunar syndromes.

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Cerebral ischemia diagnosis often relies on diffusion-weighted imaging (DWI).
  • The occurrence and predictors of DWI-negative cerebral ischemia remain unclear.
  • Understanding these cases is crucial for accurate stroke and TIA diagnosis.

Purpose of the Study:

  • To determine the frequency of DWI-negative cerebral ischemia in patients with stroke and transient ischemic attack (TIA).
  • To identify clinical factors associated with DWI-negative findings.
  • To evaluate the utility of follow-up imaging in diagnosing these cases.

Main Methods:

  • Magnetic resonance imaging (MRI) including DWI was performed on 401 patients within 24 hours of symptom onset.
  • Follow-up MRI was conducted at 30 days for all patients.
  • Clinical data and final diagnoses were analyzed.

Main Results:

  • 103 out of 401 patients (25.6%) presented with an initial negative DWI.
  • In the DWI-negative group, 23.1% of stroke patients and 3.2% of TIA patients showed infarcts on follow-up MRI.
  • Perfusion imaging detected ischemia in some DWI-negative cases, and specific syndromes (brainstem, lacunar) were more likely to be DWI-negative initially but confirmed later.

Conclusions:

  • Baseline perfusion imaging may identify ischemia in a portion of DWI-negative patients.
  • DWI-negative findings with subsequent infarct confirmation or stroke diagnosis were associated with brainstem or lacunar syndromes.
  • These findings highlight the importance of considering follow-up imaging and clinical diagnosis in DWI-negative stroke and TIA evaluations.