DIFFUSION-WEIGHTED MAGNETIC-RESONANCE-IMAGING OF COMPROMISED TISSUE IN STROKE

Diffusion weighted imaging (DWI) and T2 weighted magnetic resonance im aging were performed on at least two occasions in 28 children presenti ng with stroke. In previous reports of DWI in human stroke, eventual i nfarction was observed (with only one exception) in all regions in whi ch early DWI hyperintensity occurred. In the present report, two child ren had regions of DWI hyperintensity which did not progress to infarc tion. One patient who presented with right hemiplegia showed extensive high signal on DWI, with T2 evidence of tissue swelling but without h yperintensity. DWI changes persisted over weeks, with no imaging indic ation of infarction. This child recovered completely. A second child w ho had a major vessel infarct with concomitant regions of hyperintensi ty on T2 weighted imaging and DWI, also had DWI hyperintensity in an a djacent territory which did not develop any subsequent evidence of inf arction. Thus in clinical practice DWI can demonstrate tissue which is compromised but not irreversibly so.