Published Online
on January 15, 2004

A more recent version of this article appeared on February 1, 2004

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Submitted on August 28, 2003
Accepted on October 14, 2003

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; and 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.

^* To whom correspondence should be addressed. 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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