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(Stroke. 2004;35:469.)
© 2004 American Heart Association, Inc.

Original Contributions

Mild Neurological Symptoms Despite Middle Cerebral Artery Occlusion

Shelagh B. Coutts, MBChB; Philip A. Barber, MBChB; Andrew M. Demchuk, MD; Michael D. Hill, MD; J.H. Warwick Pexman, MBChB; Mark E. Hudon, MD Alastair M. Buchan, MD

From the Department of Clinical Neurosciences (S.B.C., P.A.B., A.M.D., M.D.H., J.H.W.P., M.E.H., A.M.B.) and Radiology (M.E.H.), University of Calgary; Seaman Family MR Centre (S.B.C., A.M.D., J.H.M.P.); and Departments of Medicine and Community Health Sciences, Foothills Medical Centre (M.D.H.), Calgary, Alberta, Canada.

Correspondence to Dr Shelagh B. Coutts, Seaman Family MR Centre, Foothills Hospital, 1403 29th St NW, Calgary, Alberta T2N 2T9, Canada. E-mail shelagh.coutts{at}calgaryhealthregion.ca

Background and Purpose— Only a small percentage of stroke patients are treated with thrombolytic therapy. We sought to determine whether vessel occlusion in mild strokes represented a new target population for interventional therapy.

Methods— We imaged 106 acute stroke patients with MRI. Patients were identified with evidence of middle cerebral artery (MCA) occlusion and mild or no stroke signs (National Institutes of Health Stroke Scale [NIHSS] 3). They were compared with patients with signs of stroke, NIHSS >3, and MCA occlusion.

Results— We identified 5 patients with absent flow on MRA in the MCA and mild or no stroke signs (NIHSS 3). All 5 were functionally independent at 3 months.

Conclusions— Caution should be exercised in considering thrombolytic therapy in these patients. Quantification of perfusion imaging is required to identify "at risk" mild stroke populations.

Key Words: magnetic resonance imaging • stroke

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