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Stroke Mimics - Other Causes of Restricted Diffusion

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Today, we're going to talk about stroke mimics or other causes

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of restricted diffusion. They're not acute ischemic strokes.

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So one cause is seizure.

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It usually has cortical restricted diffusion,

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frequently in the temporal lobe,

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but sometimes in the frontal and parietal lobes.

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Frequently, the thalamus is involved because it's a relay station

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between the cortex and the brainstem, and it's

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usually in a non-arterial distribution.

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MELAS can also cause strokes of multiple ages

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in non-arterial distributions.

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Hypoglycemia can cause restricted diffusion.

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It frequently involves the occipital and parietal lobes,

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but can involve other areas as well.

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HSV encephalitis is a necrotizing encephalitis

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and can frequently involve the limbic system.

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The patients present with fever and seizures

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and behavioral changes.

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Central pontine myelinolysis is usually caused by rapid

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correction of sodium.

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You see it in the central pons

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versus the hemipons,

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which is what you see with acute infarction.

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And Metastases can cause restricted diffusion

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due to dense cell packing.

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They usually have enhancement

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but early strokes do not have enhancement.

Report

Faculty

Pamela W Schaefer, MD, FACR

Professor of Radiology, Vice Chair of Education

Massachusetts General Hospital

Tags

Vascular Imaging

Perfusion

Neuroradiology

Neuro

MRP

MRI

MRA

Head and Neck

CTP

CTA

CT

Brain

Angiography

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