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J Neurol Neurosurg Psychiatry 2002;72:572-575 doi:10.1136/jnnp.72.5.572
  • Paper

Diffusion weighted magnetic resonance imaging in the diagnosis of reversible ischaemic deficits of the brainstem

  1. J J Marx1,
  2. A Mika-Gruettner1,
  3. F Thoemke1,
  4. S Fitzek3,
  5. C Fitzek4,
  6. G Vucurevic2,
  7. P P Urban1,
  8. P Stoeter2,
  9. H C Hopf1
  1. 1Department of Neurology, University of Mainz, Germany
  2. 2Department of Neuroradiology, University of Mainz
  3. 3Department of Neurology, University of Jena, Germany
  4. 4Department of Radiology, University of Jena
  1. Correspondence to:
 Dr Marx, Department of Neurology, University of Mainz, Langenbeckstrasse 1, D-55101 Mainz, Germany;
 marx{at}neurologie.klinik.uni-mainz.de
  • Received 23 April 2001
  • Accepted 23 October 2001
  • Revised 6 August 2001

Abstract

Objectives: To evaluate the sensitivity of diffusion weighted magnetic resonance imaging (MRI) for the diagnosis of clinically suspected reversible ischaemic deficits of the brainstem.

Methods: A total of 158 consecutive patients presenting with acute signs of brainstem dysfunction were investigated using EPI diffusion weighted MRI within 24 hours of the onset of symptoms. High resolution T1 and T2 weighted imaging was performed as a follow up after a median of six days

Results: Fourteen of the 158 patients had a complete clinical recovery within 24 hours (transitory ischaemic attack (TIA)), and 19 patients recovered in less than one week (prolonged reversible neurological deficit (RIND)). Diffusion weighted MRI showed acute ischaemic deficits in 39% of patients with transient neurological deficits. The detection rate seemed to be higher in patients with longer lasting symptoms, but the difference between patients with TIA (29%) and RIND (47%) was not significant.

Conclusions: Diffusion weighted MRI is a sensitive indicator of acute ischaemic brainstem deficits even in patients with reversible neurological deficit. Early identification of patients with TIA and increased risk of stroke may influence acute management and improve patient outcome.

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