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Case Reports
. 2020 Nov 5;12(11):e11352.
doi: 10.7759/cureus.11352.

False-Negative Initial Magnetic Resonance Imaging in Acute Posterior Circulation Stroke: A Case Report Describing Locked-in Syndrome

Christian L Castaneda  1 , Jee Ah Christina Rhee  2 , Joon Ha H Woo  3 , Michael P Lerario  4   5
Affiliations
Case Reports

False-Negative Initial Magnetic Resonance Imaging in Acute Posterior Circulation Stroke: A Case Report Describing Locked-in Syndrome

Christian L Castaneda et al. Cureus. .

Abstract

Locked-in syndrome is defined as quadriplegia and anarthria with the preservation of consciousness. Typically, locked-in syndrome is caused by an insult to the ventral pons secondary to trauma or vascular disease. Presented herein is a case of a locked-in syndrome with an initial MRI with no restricted diffusion and clinical deterioration over the course of four days. Repeat interval MRI demonstrated bilateral pontine ischemia.

Keywords: magnetic resonance imaging (mri); neurocritical care; posterior circulation; stroke.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. MRI slice of the pons on admission vs Day 5
Displayed are fluid-attenuated inversion recovery (FLAIR) sequences showing no acute pathology initially. Follow-up magnetic resonance imaging displayed bilateral basilar pontine infarcts not previously seen. These findings correlated with the patient’s clinical deterioration.
See this image and copyright information in PMC

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