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Updated: Mar 8, 2026
Focal Cerebral Ischemia Model by Endovascular Suture Occlusion of the Middle Cerebral Artery in the Rat
Published on: February 5, 2011
[Ischemic stroke despite normal brain MRI: about a case]
Glorien Lemahafaka1, Ansoumane Camara1, Lala Rajaonarison2
1Service de Neurologie, Centre Hospitalier de Pontarlier, France.
Abstract:
MRI remains the current gold standard imaging modality to diagnose ischemic stroke. MRI sensitivity for acute ischemic stroke detection does not always reach 100%. We report the case of a patient with ischemic stroke despite normal initial brain MRI. Normal brain MRI during the early phase of ischemic stroke raises doubt about the indication for thrombolysis which is the treatment of choice for cerebral embolism. The repetition of fine cut examination by B2000 diffusion weighted imaging (DWI) enables the early detection of small volume infarction not visualized by conventional brain MRI.
Insights
A normal brain MRI can miss early ischemic stroke. Repeating diffusion-weighted imaging (DWI) with fine cuts can detect small infarcts missed by standard MRI, aiding timely thrombolysis treatment.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Magnetic Resonance Imaging (MRI) is the standard for diagnosing ischemic stroke.
- However, MRI's sensitivity is not always 100% for acute ischemic stroke detection.
Observation:
- A case study revealed a patient with ischemic stroke despite an initially normal brain MRI.
- This normal finding during the early stroke phase can create uncertainty regarding thrombolysis, a critical treatment for cerebral embolism.
Findings:
- Repeating MRI with fine-cut, high-b-value (2000 s/mm²) diffusion-weighted imaging (DWI) enabled early detection.
- This advanced DWI technique identified small-volume infarcts not visible on conventional MRI sequences.
Implications:
- Early detection of subtle infarcts is crucial for appropriate and timely thrombolytic therapy.
- Advanced DWI sequences improve diagnostic accuracy in challenging ischemic stroke cases.
- This highlights the importance of advanced imaging techniques when clinical suspicion remains high despite initial negative results.
