Stroke syndromes associated with DWI-negative MRI include ataxic hemiparesis and isolated internuclear ophthalmoplegia

We present a case series of clinically definite acute stroke with negative diffusion-weighted imaging (DWI). This study retrospectively examined a large population of stroke patients with the aim of identifying which stroke syndromes were more likely to be negative on MRI. Patient records and images were reviewed in order to confirm clinically definite stroke and DWI negativity. A total of 701 patients had MRI during the study period. A total of 16 patients with DWI-negative MRI and clinically definite stroke as diagnosed by experienced stroke consultants were identified. A total of 15 of the 16 cases were classified as either posterior circulation or lacunar strokes, and the most common syndromes were ataxic hemiparesis and isolated internuclear ophthalmoplegia.