Related Experiment Video
Updated: Jun 13, 2026

A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Benign oligemia despite a malignant MRI profile in acute ischemic stroke
Oh Young Bang1, Kwang Ho Lee, Suk Jae Kim
1Department of Neurology and the Stroke and Cerebrovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Background:
It has recently been suggested that diffusion and perfusion MRI can identify subgroups likely to benefit or potentially be harmed by reperfusion therapies.
Case Report:
We investigated serial MRI data of two patients with occlusion of the proximal middle cerebral artery (MCA). In both cases, acute multiple cortical infarcts evident on diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) showed extensive areas of severe perfusion delays, indicating a malignant MRI profile. However, despite the malignant MRI profiles in these cases, no new ischemic lesions or hemorrhage evolved even in the presence of persistent arterial occlusion, and the patients recovered without sequelae.
Conclusions:
These two cases suggest that time-domain PWI findings should be interpreted with caution in certain scenarios of acute ischemic stroke.
Related Concept Videos
Ischemic Stroke ll: Pathophysiology
Ischemic Stroke l: Introduction
Transient Ischemic Attack l: Introduction
Hemorrhagic Stroke ll: Pathophysiology
Hemorrhagic Stroke l: Introduction
Magnetic Resonance Imaging

