A 60-year-old patient presented to the emergency department with sudden onset neurological symptoms suggestive of a cerebrovascular event. Initial diagnostic imaging revealed a complex clinical picture with an unclear diagnosis, with differentials including aneurysm, neoplasm, ischaemia accompanied by cerebral oedema. CT angiography revealed a small aneurysm, while subsequent MRI demonstrated findings consistent with diffuse multifocal glioma and areas of restricted diffusion, suggesting post-compressive ischaemia. This case highlights both the diagnostic challenges of using CT imaging for early suspected stroke and the importance of multimodal imaging when the clinical diagnosis is uncertain.
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Green et al. (2024) studied this question.
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