Silent Ischemic Stroke Presenting as Low-level 99mTc-HDP Uptake on Bone Scintigraphy

Stroke is typically a clinical diagnosis, yet in rare instances, it may be incidentally detected in patients who appear asymptomatic until formal assessment is undertaken. This case highlights a 62-year-old woman with recently diagnosed lobular breast cancer undergoing a staging technetium‑99m hydroxydiphosphonate ( 99m Tc-HDP) bone scan, which revealed low-level tracer uptake in the right parietal region. Subsequent CT imaging confirmed a subacute parietal infarct. While previous reports have documented 99m Tc-HDP uptake in ischemic stroke, this case underscores the variable scintigraphic appearance depending on the timing relative to the index event and reinforces the importance of correlating unexpected findings with clinical context.