Acute stroke syndrome with fixed neurological deficit and false-negative diffusion-weighted imaging

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Abstract

Diffusion-weighted imaging (DWI) is sensitive for the detection of acute ischemic stroke. However, a negative DWI study of the brain does not always exclude a patient from the possibility of acute cerebral ischemia. The authors report 1 case in which the patient presented with a fixed ischemic neurological deficit (National Institute of Health Stroke Scale score = 22) that included global aphasia, right hemiparesis, and a right visual field neglect. The initial DWI of the brain within 27 hours of symptom onset was negative. The deficit persisted, and a repeat magnetic resonance imaging study 7 days later showed a large area of restricted diffusion involving the gray matter of the entire left middle cerebral artery and anterior cerebral artery distribution, indicating a large area of cortical stroke.

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Wang, W., Goldstein, S., Scheuer, M. L., & Branstetter, B. F. (2003). Acute stroke syndrome with fixed neurological deficit and false-negative diffusion-weighted imaging. Journal of Neuroimaging, 13(2), 158–161. https://doi.org/10.1177/1051228403251632

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