Key result
Initial diffusion-weighted MRI performed at 6 hours post symptom onset was negative in a 20-year-old female with Claude's syndrome, highlighting the need for clinical diagnosis in hyperacute posterior circulation stroke.
Case Report (n=1)
Initial DWI MRI can be negative in hyperacute posterior circulation infarcts, emphasizing the importance of clinical history and examination.
Diffusion weighted imaging is the most sensitive technique for diagnosis of acute ischaemic stroke and is often relied upon for clinical decision making. We report a case of a 20 year of female presenting with Claude's syndrome which was DWI negative on MRI performed at 6 hours post symptom onset. Repeat MRI was performed, revealing acute infarction in the Left paramedian midbrain. Secondary causes were excluded. This case highlights the importance of history and examination skills as the primary diagnostic tools for acute ischaemic stroke, with neuroimaging being utilised as an adjunct to confirm diagnosis. This is especially true in hyperacute cases with posterior circulation symptoms.
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Gillinder et al. (2018) conducted a case report in Acute ischaemic stroke (Claude's syndrome) (n=1). Diffusion weighted imaging (DWI) was evaluated on Diagnosis of acute ischaemic stroke. Initial diffusion-weighted MRI performed at 6 hours post symptom onset was negative in a 20-year-old female with Claude's syndrome, highlighting the need for clinical diagnosis in hyperacute posterior circulation stroke.
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