| Summary: | Abstract Background Generally, Diffusion-weighted MR imaging (DWI) is known to be more sensitive in diagnosis of acute stroke than other MR sequences. However, fluid attenuated inversion recovery (FLAIR) MR sequence founded to be sometimes more sensitive compared to DWI for the diagnosis of hyperacute stroke. Case presentation An 84 years old female patient brought to ER by ambulance due to loss of speech, dizziness and confusion. Neurological examination showed that the patient can raise her left hand and leg while partially moving her right hand and right leg. The patient had slurred speech. Provisional diagnosis was acute stroke and the patient admitted in the hospital. Non contrast CT scan of the brain was done, was negative for stroke. Then MRI was done showed no areas of restricted diffusion at the DWI sequence or ADC map. Prominent high signal vessels at the left temporal region and on Sylvian fissure were noticed on FLAIR sequence that might have suggested early sign of ischemic vascular insult. Conclusions Arterial hyperintensity on FLAIR images can precede diffusion abnormalities and may provide a clue to the early detection of impending infarction.
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