This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mader, I. Articles by Küker, W. Search for Related Content PubMed PubMed Citation Articles by Mader, I. Articles by Küker, W. Related Collections Acute Cerebral Infarction Computerized tomography and Magnetic Resonance Imaging Stroke in Children and the Young

(Stroke. 2002;33:1142.)
© 2002 American Heart Association, Inc.

Case Report

Neonatal Cerebral Infarction Diagnosed by Diffusion-Weighted MRI

Pseudonormalization Occurs Early

Irina Mader, MD; Martin Schöning, MD; Uwe Klose, MD Wilhelm Küker, MD

From the Departments of Neuroradiology (I.M., U.K., W.K.) and Neuropediatrics (M.S.), Medical School, University of Tübingen (Germany).

Correspondence to Dr Wilhelm Küker, Department of Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany. E-mail wmkueker{at}med.uni-tuebingen.de

Background— Seizures in the neonatal period may be the single symptom of acute ischemic cerebral infarction. It may be difficult to establish the diagnosis in the acute phase by the use of ultrasound, CT, and conventional MRI because of the high water content of the immature brain. Diffusion-weighted (DW) MRI is a very sensitive and fast imaging modality to visualize acute ischemic stroke in infants even before conventional MR images become abnormal. Signal abnormality in DW MRI, however, seems to follow a different time course than in older patients.

Case Description— DW MRI became falsely negative 1 week after stroke (pseudonormalization) in 2 newborn patients during persistence of signal abnormalities on turbo spin-echo images, whereas the so-called pseudonormalization in adults normally occurs within 10 to 14 days.

Conclusions— T2-weighted sequences should supplement DW images to reliably detect subacute ischemic infarctions in the neonatal period.

Key Words: cerebral infarction • infants • magnetic resonance imaging, diffusion-weighted

This article has been cited by other articles:

				J. Dudink, E. Mercuri, L. Al-Nakib, P. Govaert, S.J. Counsell, M.A. Rutherford, and F.M. Cowan Evolution of Unilateral Perinatal Arterial Ischemic Stroke on Conventional and Diffusion-Weighted MR Imaging AJNR Am. J. Neuroradiol., May 1, 2009; 30(5): 998 - 1004. [Abstract] [Full Text] [PDF]

				L. Liauw, G. van Wezel-Meijler, S. Veen, M.A. van Buchem, and J. van der Grond Do Apparent Diffusion Coefficient Measurements Predict Outcome in Children with Neonatal Hypoxic-Ischemic Encephalopathy? AJNR Am. J. Neuroradiol., February 1, 2009; 30(2): 264 - 270. [Abstract] [Full Text] [PDF]

				L. Liauw, J. van der Grond, A. A. van den Berg-Huysmans, I. H. Palm-Meinders, M. A. van Buchem, and G. van Wezel-Meijler Hypoxic-Ischemic Encephalopathy: Diagnostic Value of Conventional MR Imaging Pulse Sequences in Term-born Neonates Radiology, April 1, 2008; 247(1): 204 - 212. [Abstract] [Full Text] [PDF]

				Y Cheng, G R Liu, J T Guan, Y L Guo, Y K Li, and R H Wu Early diffusion weighted imaging and expression of heat shock protein 70 in newborn pigs with hypoxic ischaemic encephalopathy Postgrad. Med. J., September 1, 2005; 81(959): 589 - 593. [Abstract] [Full Text] [PDF]

				M. Rutherford, S. Counsell, J. Allsop, J. Boardman, O. Kapellou, D. Larkman, J. Hajnal, D. Edwards, and F. Cowan Diffusion-Weighted Magnetic Resonance Imaging in Term Perinatal Brain Injury: A Comparison With Site of Lesion and Time From Birth Pediatrics, October 1, 2004; 114(4): 1004 - 1014. [Abstract] [Full Text] [PDF]