CEREBROSPINALECTOMYRegistrar: "Where is it?" Me: "Left lateral medulla." Registrar: "The scan is not back." Me: "The scan is going to agree with me." Registrar: "And if it does not?" Me: "Then the scan is early." What's the version at your hospital? Send this to whoever still examines before they scan.
EXPLAINED (ACCURACY-CHECKED)
Early diffusion-weighted MRI can be falsely negative in acute ischaemic stroke, and false negatives are disproportionately reported in posterior circulation and brainstem infarcts, so a negative early scan does not exclude a clinically localised lesion.
PubMed PMID 38737347 and PMID 26169550 — false-negative DWI in acute ischaemic stroke is well described and over-represented in posterior circulation lesions.
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