Vol 49, No 6 (2015)

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Emergency microsurgical embolectomy in acute ischemic stroke with diffusion-negative MRI

Ki Seong Eom1, Daw Won Kim1, Sungdon Kang1
DOI: 10.1016/j.pjnns.2015.08.001
Neurol Neurochir Pol 2015;49(6):432-435.

Abstract

Although diffusion-weighted imaging (DWI) is highly sensitive and specific for the detection of acute ischemic injury, there are increasing reports that it may fail to demonstrate an acute stroke. Here, we present a case involving an acute ischemic stroke with a false-negative DWI in a 64-year-old woman who had undergone an emergency microsurgical embolectomy for an occluded middle cerebral artery (MCA). Although the endovascular mechanical embolectomy failed in treating the occluded MCA, we were able to successfully treat our patient with the second treatment option of a microsurgical embolectomy. Microsurgical embolectomy might be the treatment of choice, especially if the mechanical catheter is expected to not be able to access the target artery due to tortuous vascular structures.

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