Hyperintense Acute Reperfusion Marker on FLAIR in a Patient with Transient Ischemic Attack
The hyperintense acute reperfusion marker (HARM) has initially been described in acute ischemic stroke. The phenomenon is caused by blood-brain barrier disruption following acute reperfusion and consecutive delayed gadolinium enhancement in the subarachnoid space on fluid attenuated inversion recove...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-01-01
|
| Series: | Case Reports in Radiology |
| Online Access: | http://dx.doi.org/10.1155/2016/9829823 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850158370490679296 |
|---|---|
| author | Alex Förster Holger Wenz Christoph Groden |
| author_facet | Alex Förster Holger Wenz Christoph Groden |
| author_sort | Alex Förster |
| collection | DOAJ |
| description | The hyperintense acute reperfusion marker (HARM) has initially been described in acute ischemic stroke. The phenomenon is caused by blood-brain barrier disruption following acute reperfusion and consecutive delayed gadolinium enhancement in the subarachnoid space on fluid attenuated inversion recovery (FLAIR) images. Here we report the case of an 80-year-old man who presented with transient paresis and sensory loss in the right arm. Initial routine stroke MRI including diffusion- and perfusion-weighted imaging demonstrated no acute pathology. Follow-up MRI after three hours demonstrated subarachnoid gadolinium enhancement in the left middle cerebral artery territory consistent with HARM that completely resolved on follow-up MRI three days later. This case illustrates that even in transient ischemic attack patients disturbances of the blood-brain barrier may be present which significantly exceed the extent of acute ischemic lesions on diffusion-weighted imaging. Inclusion of FLAIR images with delayed acquisition after intravenous contrast agent application in MRI stroke protocols might facilitate the diagnosis of a recent acute ischemic stroke. |
| format | Article |
| id | doaj-art-64010ca2be104f3fbaee4d6356e15bbd |
| institution | OA Journals |
| issn | 2090-6862 2090-6870 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Radiology |
| spelling | doaj-art-64010ca2be104f3fbaee4d6356e15bbd2025-08-20T02:23:53ZengWileyCase Reports in Radiology2090-68622090-68702016-01-01201610.1155/2016/98298239829823Hyperintense Acute Reperfusion Marker on FLAIR in a Patient with Transient Ischemic AttackAlex Förster0Holger Wenz1Christoph Groden2Department of Neuroradiology, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyDepartment of Neuroradiology, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyDepartment of Neuroradiology, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyThe hyperintense acute reperfusion marker (HARM) has initially been described in acute ischemic stroke. The phenomenon is caused by blood-brain barrier disruption following acute reperfusion and consecutive delayed gadolinium enhancement in the subarachnoid space on fluid attenuated inversion recovery (FLAIR) images. Here we report the case of an 80-year-old man who presented with transient paresis and sensory loss in the right arm. Initial routine stroke MRI including diffusion- and perfusion-weighted imaging demonstrated no acute pathology. Follow-up MRI after three hours demonstrated subarachnoid gadolinium enhancement in the left middle cerebral artery territory consistent with HARM that completely resolved on follow-up MRI three days later. This case illustrates that even in transient ischemic attack patients disturbances of the blood-brain barrier may be present which significantly exceed the extent of acute ischemic lesions on diffusion-weighted imaging. Inclusion of FLAIR images with delayed acquisition after intravenous contrast agent application in MRI stroke protocols might facilitate the diagnosis of a recent acute ischemic stroke.http://dx.doi.org/10.1155/2016/9829823 |
| spellingShingle | Alex Förster Holger Wenz Christoph Groden Hyperintense Acute Reperfusion Marker on FLAIR in a Patient with Transient Ischemic Attack Case Reports in Radiology |
| title | Hyperintense Acute Reperfusion Marker on FLAIR in a Patient with Transient Ischemic Attack |
| title_full | Hyperintense Acute Reperfusion Marker on FLAIR in a Patient with Transient Ischemic Attack |
| title_fullStr | Hyperintense Acute Reperfusion Marker on FLAIR in a Patient with Transient Ischemic Attack |
| title_full_unstemmed | Hyperintense Acute Reperfusion Marker on FLAIR in a Patient with Transient Ischemic Attack |
| title_short | Hyperintense Acute Reperfusion Marker on FLAIR in a Patient with Transient Ischemic Attack |
| title_sort | hyperintense acute reperfusion marker on flair in a patient with transient ischemic attack |
| url | http://dx.doi.org/10.1155/2016/9829823 |
| work_keys_str_mv | AT alexforster hyperintenseacutereperfusionmarkeronflairinapatientwithtransientischemicattack AT holgerwenz hyperintenseacutereperfusionmarkeronflairinapatientwithtransientischemicattack AT christophgroden hyperintenseacutereperfusionmarkeronflairinapatientwithtransientischemicattack |