Acute Ischemic Stroke Lasting for 5 Days Without Definite Lesions on Diffusion-Weighted Magnetic Resonance Imaging in a Patient With Severe Leukoaraiosis

• Published in: Journal of stroke and cerebrovascular diseases Vol. 20; no. 5; pp. 482 - 484
• Main Authors: Han, Soo Jeong, MD, Kim, Beum Saeng, MD, PhD, Shon, Young Min, MD, PhD, Cho, A.-Hyun, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2011
• Subjects: Acute ischemic stroke; Brain Ischemia - diagnosis; Brain Ischemia - etiology; Brain Ischemia - pathology; Brain Ischemia - physiopathology; Cardiovascular; Cerebral Angiography - methods; Cerebrovascular Circulation; Diffusion Magnetic Resonance Imaging; diffusion-weighted MRI; Female; Humans; leukoaraiosis; Leukoaraiosis - complications; Leukoaraiosis - diagnosis; Leukoaraiosis - pathology; Leukoaraiosis - physiopathology; Middle Aged; Middle Cerebral Artery - diagnostic imaging; Middle Cerebral Artery - pathology; Middle Cerebral Artery - physiopathology; Neurology; Perfusion Imaging - methods; Predictive Value of Tests; Severity of Illness Index; Stroke - diagnosis; Stroke - etiology; Stroke - pathology; Stroke - physiopathology; Time Factors; Tomography, X-Ray Computed; leukoaraiosis; Acute ischemic stroke; diffusion-weighted MRI
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2010.02.010

The reported frequency of false-negative diffusion-weighted magnetic resonance imaging (DWI) cases is 3.5%-25%. However, territorial stroke (eg, middle cerebral artery territory) with negative DWI is very rare. We report a case of territorial ischemic stroke persisting for 5 days without identification of a definite lesion on DWI but with decreased perfusion on perfusion computed tomography in a patient with underlying severe leukoaraiosis. This case suggests that severe leukoaraiosis might be responsible for the negative finding on DWI in acute ischemic stroke.