Detection of acute thalamo-mesencephalic infarction: diffusion abnormality precedes T2 hyperintensity

Acta Neurol Scand. 2003 Jul;108(1):52-4. doi: 10.1034/j.1600-0404.2003.00094.x.


Objective: To examine the time course of signal changes in diffusion-weighted magnetic resonance imaging (DW-MRI) and T2-weighted MRI in a case of cerebral infarction in the posterior circulation territory.

Materials and methods: Diffusion- and T2-weighted MRI and comparison of signal changes in these sequences at 4 h, 1 day and 4 days after the onset of clinical symptoms caused by acute thalamo-mesencephalic infarction.

Results: Four hours after the onset of symptoms, signal changes in DW-MRI revealed an infarction in the territory of the posterior perforating thalamic artery, whereas no signal changes were detected in T2-weighted MRI. In follow-up MRI 1 and 4 days after infarction, however, a marked hyperintensity matching the location of the diffusion deficit could be identified in T2 images.

Conclusion: Signal changes in DW-MRI precede T2 hyperintensity after infarction in the posterior circulation territory after hemispheric infarction.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Brain Infarction / pathology*
  • Brain Infarction / physiopathology*
  • Diffusion Magnetic Resonance Imaging*
  • Disease Progression
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Mesencephalon / pathology*
  • Mesencephalon / physiopathology*
  • Thalamus / pathology*
  • Thalamus / physiopathology*
  • Time Factors