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Outcome of Stroke Patients without Angioigraphically Revealed Arterial Oclussion within Four Hours of Symptom Onset AJNR 22:685-690, Derex, L.,et al, 2001 See this aricle in Pubmed Article Abstract Acute ischemic stroke patients with a neurologic deficit but a negative angiogram during the first 4 hours after symptom onset usually develop image-documented cerebral infarction, and approximately half suffer from long-term functional disa bility. The two most likely explanations for negative angiograms are very early irreversible ischemic damage despite recanalization or ongoing ischemia secondary to clot in non-visible penetrating arterioles or in the microvasculature.

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