Transient Focal Neurologic Symptoms Correspond to Regional Cerebral Hypoperfusion by MRI: A Stroke Mimic in Children.
Laura L LehmanA R DanehyC C TrenorChristopher CalahanMiya E Bernson-LeungRichard L RobertsonMichael J RivkinPublished in: AJNR. American journal of neuroradiology (2017)
Children who present with acute transient focal neurologic symptoms raise concern for stroke or transient ischemic attack. We present a series of 16 children who presented with transient focal neurologic symptoms that raised concern for acute stroke but who had no evidence of infarction and had unilateral, potentially reversible imaging features on vascular and perfusion-sensitive brain MR imaging. Patients were examined with routine brain MR imaging, MRA, perfusion-sensitive sequences, and DWI. Fourteen (88%) children had lateralized MRA evidence of arterial tree pruning without occlusion, all had negative DWI findings, and all showed evidence of hemispheric hypoperfusion by susceptibility-weighted imaging or arterial spin-labeling perfusion imaging at presentation. These findings normalized following resolution of symptoms in all children who had follow-up imaging (6/16, 38%). The use of MR imaging with perfusion-sensitive sequences, DWI, and MRA can help to rapidly distinguish children with conditions mimicking stroke from those with acute stroke.
Keyphrases
- contrast enhanced
- diffusion weighted
- cerebral ischemia
- young adults
- diffusion weighted imaging
- magnetic resonance imaging
- high resolution
- magnetic resonance
- computed tomography
- atrial fibrillation
- end stage renal disease
- depressive symptoms
- multiple sclerosis
- ejection fraction
- subarachnoid hemorrhage
- peritoneal dialysis
- brain injury
- molecular dynamics
- resting state
- intensive care unit
- case report
- functional connectivity
- ionic liquid