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[Features of MRI diffusion weighted image in early stage of lateral medullary infarction presenting Wallenberg
Abstract:
We described early features of MRI diffusion weighted images (DWIs) in three patients with lateral medullary infarction. Patient 1. A 65-year-old woman who complained of vertigo was admitted. Then, DWIs showed a high signal intensity in the right lateral medulla, though T2 weighted images (T2WIs) did not show any abnormalities. On the next day, when the typical symptoms and signs of lateral medullary infarction appeared, the lesion was recognized on both DWIs and T2WIs. Patient 2. A 48-year-old man was admitted 9 hours after he had dizziness, nausea, and repeated vomitings. When a diagnosis of Wallenberg syndrome was made on the neurological examination, MRI DWIs demonstrated a high signal intensity in the right lateral medulla. The lesion became apparent on T2WIs 82 hours after the onset. Patient 3. A 71-year-old man was admitted for nausea, dizziness, and repeated vomitings. A diagnosis of Wallenberg syndrome was made fifty eight hours after the onset, a lesion with high signal intensity in the right lateral medulla was evident on DWIs, but it was faint on T2WIs. We concluded that DWIs is useful in early diagnosis of lateral medullary infarction presenting Wallenberg syndrome.
Insights
Diffusion-weighted images (DWIs) detect early lateral medullary infarction, a type of stroke. This MRI technique aids in the prompt diagnosis of Wallenberg syndrome, improving patient outcomes.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Lateral medullary infarction, often presenting as Wallenberg syndrome, can be challenging to diagnose early.
- Timely diagnosis is crucial for effective stroke management and patient prognosis.
Observation:
- This study examined three patients with suspected lateral medullary infarction.
- Magnetic Resonance Imaging (MRI) Diffusion-Weighted Images (DWIs) were analyzed for early diagnostic features.
- T2-weighted images (T2WIs) were used for comparison.
Findings:
- DWIs revealed high signal intensity in the lateral medulla in all three patients, indicating acute infarction.
- In two patients, abnormalities were not initially visible on T2WIs, highlighting the sensitivity of DWIs.
- Lesions became apparent on T2WIs later, with one case showing a faint signal after 58 hours.
Implications:
- DWIs are a valuable tool for the early detection of lateral medullary infarction.
- Utilizing DWIs can lead to a faster diagnosis of Wallenberg syndrome.
- Early MRI diagnosis facilitates prompt therapeutic interventions for stroke patients.