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The 10-second stroke: a case report
Matthew S Siket1, Brian Silver2
1Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, Rhode Island.
Background:
Acute infarction is detected in a third of patients undergoing diffusion-weighted magnetic resonance imaging (DW-MRI) with clinically suspected transient ischemic attack. The longer symptoms are present, the more likely an infarct will be identified on DW-MRI. Events as short as 10 minutes have been reported in association with a DW-MRI lesion.
Methods:
We present a case of an otherwise healthy man with a 10-second episode of neurologic dysfunction associated with DW-MRI lesions from a cardioembolic source.
Results:
The atypical symptoms and lack of risk factors for cerebrovascular disease made his diagnosis easy to miss.
Conclusions:
Early DW-MRI may be of benefit beyond clinical judgment in patients with fleeting symptoms of neurologic dysfunction.
Insights
Diffusion-weighted MRI (DW-MRI) can detect acute infarction even with very brief neurological symptoms. Early imaging aids diagnosis when clinical judgment is insufficient for transient ischemic attack.
Area of Science:
- Neurology
- Radiology
- Cardiology
Background:
- Diffusion-weighted magnetic resonance imaging (DW-MRI) detects acute infarction in one-third of patients with suspected transient ischemic attack (TIA).
- Infarct identification on DW-MRI increases with symptom duration.
- Short events, even 10 minutes, have been linked to DW-MRI lesions.
Observation:
- A case study of a healthy man with a 10-second neurological dysfunction episode.
- The patient presented with atypical symptoms and no traditional risk factors for cerebrovascular disease.
- The presentation made the diagnosis challenging.
Findings:
- The patient exhibited DW-MRI lesions originating from a cardioembolic source.
- Despite the brief and atypical symptoms, DW-MRI identified acute infarction.
- The diagnosis was initially difficult due to the lack of typical risk factors and symptom duration.
Implications:
- Early DW-MRI may be crucial for diagnosing infarction in patients with fleeting neurological symptoms.
- DW-MRI can provide diagnostic value beyond clinical assessment in TIA cases.
- This case highlights the utility of advanced imaging in identifying subtle or atypical cerebrovascular events.
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