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False-negative Diffusion-Weighted MR Findings in Acute Ischemic Stroke
AJNR 21:1434-1440, Oppenheim,C. et al, 2000
See this aricle in Pubmed
Article Abstract
We found eight cases (5.8%) of false-negative initial DWI studies, of which four were positive on initial fluid-attenuated inversion recovery (FLAIR) imaging. Follow-up FLAIR/DWI showed a hyperintensity matching clinical presentation in all eight patients. The mean size of the lesion was 0.19 +/= 0.16 cm^3. False-negative studies occurred more often in cases of stroke in the posterior (19%) than in the anterior (2%) circulation or when DWI was obtained within 24 hours after symptom onset.Of the six false-negative vertebrobasilar stroke lesions, five were located in the brain stem. In all, 31% of patients with vertebrobasilar ischemic stroke had a false-negative initial DWI study during the first 24 hours. A false-negative DWI study is not uncommon during the first 24 hours of ischemic stroke. Vertebrobasilar stroke should therefore not be ruled out on the basis of early negative DWI, especially when symptoms persist and are suggestive of this diagnosis.
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brainstem,infarction of
cerebral infarction
cerebral ischemia
cerebrovascular accident
misdiagnosis
MRI
MRI,abnormal
MRI,diffusion weighted
MRI,early changes in CVA
MRI,false negative
transient ischemic attack
vertebral-basilar insufficiency
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