Siket Matthew S, Silver Brian
Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, Rhode Island.
Department of Neurology, Alpert Medical School of Brown University, Providence, Rhode Island.
J Stroke Cerebrovasc Dis. 2015 Jun;24(6):e133-4. doi: 10.1016/j.jstrokecerebrovasdis.2015.01.024. Epub 2015 Apr 25.
Acute infarction is detected in a third of patients undergoing diffusion-weighted magnetic resonance imaging (DW-MRI) with clinically suspected transient ischemic attack. The longer symptoms are present, the more likely an infarct will be identified on DW-MRI. Events as short as 10 minutes have been reported in association with a DW-MRI lesion.
We present a case of an otherwise healthy man with a 10-second episode of neurologic dysfunction associated with DW-MRI lesions from a cardioembolic source.
The atypical symptoms and lack of risk factors for cerebrovascular disease made his diagnosis easy to miss.
Early DW-MRI may be of benefit beyond clinical judgment in patients with fleeting symptoms of neurologic dysfunction.
在临床怀疑短暂性脑缺血发作而行弥散加权磁共振成像（DW-MRI）检查的患者中，三分之一被检测出急性梗死。症状持续时间越长，在DW-MRI上发现梗死灶的可能性就越大。有报道称，短至10分钟的发作就与DW-MRI病变相关。
我们报告一例原本健康的男性，其出现了10秒的神经功能障碍发作，伴有心源性栓塞源所致的DW-MRI病变。
非典型症状以及缺乏脑血管疾病危险因素使得他的诊断容易被漏诊。
对于有短暂性神经功能障碍症状的患者，早期DW-MRI可能比临床判断更具优势。
