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Updated: Apr 16, 2026
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Acute 'limited' magnetic resonance imaging in childhood stroke--an illustrative case
C I Miteff1, G Subramanian, J E Brown
1John Hunter Children's Hospital, Lookout Road, New Lambton Heights, Newcastle, NSW, 2305, Australia, christina.miteff@hnehealth.nsw.gov.au.
Insights
Paediatric stroke diagnosis in children can be delayed. Rapid MRI using diffusion weighted imaging (DWI) and susceptibility weighted imaging (SWI) can confirm acute ischaemic stroke quickly.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Emergency Medicine
Background:
- Paediatric stroke is a significant cause of childhood morbidity and mortality.
- Diagnostic delays are common due to overlapping symptoms with conditions like migraines and seizures, and limited access to timely imaging.
- Early diagnosis is crucial for prompt treatment and improved patient outcomes.
Observation:
- A 4-year-old boy presented to the Emergency Department with acute hemiparesis.
- The clinical presentation suggested a potential acute ischaemic stroke.
Findings:
- Magnetic Resonance Imaging (MRI) was utilized, specifically focusing on diffusion weighted imaging (DWI) and susceptibility weighted imaging (SWI) sequences.
- This targeted imaging approach allowed for the confirmation of an acute ischaemic stroke diagnosis.
Implications:
- Rapid confirmation of paediatric stroke is achievable within 90 minutes of hospital presentation.
- The use of limited, targeted MRI sequences (DWI/SWI) can expedite diagnosis in emergency settings.
- Faster diagnosis facilitates earlier therapeutic interventions, potentially improving long-term outcomes for children with stroke.
Abstract:
Paediatric stroke is a major cause of morbidity and death in children. There is often a delay in making the diagnosis because common differential diagnoses such as migraine and seizures need to be considered and quick access to imaging is difficult. Early recognition is increasingly important for early treatment and to improve outcomes. We present the case of a 4-year-old boy who presented to the Emergency Department with acute hemiparesis. To target the provisional diagnosis of an acute ischaemic stroke, we requested magnetic resonance imaging (MRI) limited to two sequences only: diffusion weighted imaging (DWI) and susceptibility weighted imaging (SWI). We were able to confirm the diagnosis of acute ischaemic stroke within 90 min of presentation to hospital.
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