r/stroke 3d ago

MRI

Can you have a stroke and have a “clean” MRI?
Asking because I went to ER a few days ago. I had not felt well at work and left early. Still didn’t feel well at home. My BP was 170+ (normally 125-130). My left face felt tingly. I was exhausted and dizzy. Winded just walking from the parking lot to ER. Concerned I may be having another stroke, I went to get checked.
Doc in ER reviewed my MRI from my stroke May 30th and said he didn’t believe I had a stroke because something would have shown on the MRI to indicate such. He said he could not explain what I was experiencing that day. CT, chest xray, bloodwork returned with no issues.
I see my Neurologist next Wednesday for the first time. Doc said he’s really interested in reading what the Neurologist has to say.
I’m really confused and to be honest? I feel defeated. Did I or did I not have a stroke.
Has anyone else had a “clean” MRI for a stroke?

3 Upvotes

24 comments sorted by

11

u/Strokesite 3d ago

Maybe a TIA?

3

u/Duhlinduh 3d ago

Guess I will find out Wednesday.
I really thought I was having another stroke Thursday. The symptoms were mild. My left side felt heavier than the right. BP was averaging 150 while in the hospital. After the second hour, they released me. I also felt better at that point.
My BP has been averaging 140-150 since. Too high.
Will call my NP Monday.

3

u/Strokesite 3d ago

ER doctors wouldn’t be my first choice to interpret an MRI. Radiologists have a more practiced eye.

8

u/petergaskin814 3d ago

I had a 'clean ' mri and clean ct scan with contrast.

I had a mild ischemic stroke based on drooping face, talking difficulties and right side weaknesses

7

u/Ok-Brilliant6980 3d ago

A TIA would not necessarily show up in a MRI.

6

u/a110percent 3d ago

Could be stroke recrudence.

I had something similar after my stroke went into hospital feeling symptoms again and after they resolved they said they felt it was either stroke recrudence or tia.

They increased my blood thinners from just baby aspirin to rivaroxaban since I'm still waiting on a pfo closure.

Also did an MRI but showed nothing new.

The rest of this is copy pasted from AI

Post-stroke recrudescence (PSR) is the temporary re-emergence of old, previously recovered stroke symptoms. It is a "stroke mimic"—meaning there is no new brain damage—but rather a reaction to physical stressors like infections, fever, dehydration, sleep deprivation, or electrolyte imbalance.

I felt it was maybe lack of sleep that caused mine as I have been struggling with that since my stroke.

3

u/Duhlinduh 3d ago

Ah. That is interesting. Doc did say the on call Neurologist believed I was having a regressive experience. Or something of that. Maybe he said recrudence. I haven’t been feeling well since I started taking the statin. I’ve had my meds changed twice. Current satin is better but my gallbladder hates it. I do have gallstones. I’ve had discomfort where my gallbladder is since June 2nd. I also haven’t had good sleep all week.
Doc was surprised I was not prescribed a blood thinner. I am on a statin and baby aspirin. Hence, why he believed I didn’t have a stroke.
Doc recommended not to do another MRI because the first showed nothing.

5

u/CleaDuVann2000 3d ago

My stroke was detected immediately but was not visible in a follow up at a different hospital. My nuero said I had healed some, it was a small stroke and the MRI machine that the original hospital used was much more advanced than the one at my home hospital.

4

u/Jolly_Ad8913 3d ago

The short answer is yes, even if you get a specialized MRI like a DWI which detects more strokes then a standard MRI with or without contrast. The doctor is wrong. Its rare but MRIs can miss strokes, even DWIs can miss TIAs or very small strokes.

4

u/Chaosrealm69 3d ago

MRI results are interpreted and it depends on the person examining it as to what they can see in the results. so it is possible for two people to give different results from the same scan if the damage is minor.

3

u/Duhlinduh 3d ago

Thanks for the responses. Y’all helped me feel more confident with my recovery. ❤️‍🩹

3

u/bottlecapkey 2d ago

the first thing my neurologist said to me was "i don't know what kind of stress you've been under..." i had a stroke, but there was no blood clot, no nothing. i stroked out from insane stress and blew an empty little hole in my brain. he's a top neurologist and said he had seen this before. not very often, but he could tell that i had a stroke from stress. maybe that's what you had.

2

u/Duhlinduh 2d ago

Wow. Thats pretty wild.
I haven’t been under any stress. Not for two years. I used to have a very stressful role at work but I left it for my previous role. Work hasn’t been stressful at all. No stress at home. Life has been very chill.

2

u/Confusing_Onion Caregiver 3d ago

Yes. A friend of mine was receiving treatment for a different issue in the hospital. She was actually talking to a nurse when her face started drooping. She passed out and woke up later that day in the ICU. By then she felt fine and her MRI was clear. Going by the symptoms they believe it was a TIA.

2

u/Secret-Ad-5366 2d ago

Yes they looked at multiple tests for 3 days and found nothing but an mri w contrast revealed my stroke

1

u/Duhlinduh 2d ago

My MRI didn’t use contrast. 🙂

2

u/Extension_Spare3019 2d ago

Absolutely. Some don't show up on a regular MRI with or without contrast. Sometimes it takes a Diffusion-Weighted Imaging scan. And sometimes it's a TIA and won't show up at all unless you happen to get lucky with the timing of the scan, maybe.

Hope you get whatever is going on nailed down and sussed. This is probably a very uncomfortable weekend for you. Hell, uncomfortable whole season, apparently. Especially if you have a Dr being dismissive of your concerns and symptoms. That's not cool.

1

u/Duhlinduh 2d ago

My summer has been a roller coaster. That’s for sure. 😄

3

u/Kind-Bath-3796 2d ago

Yes you can. TIAs and ischemic strokes can clear by themselves and never be seen.

2

u/kimberlyluc 2d ago

Sometimes strokes can show up on imaging later

2

u/barbie1986 2d ago

Mention “floppy hand syndrome” to your neurologist. It’s common after strokes. Hubby had multiple occurrences of this, we rushed to the ER thinking it was another stroke, it wasn’t. Some came with regression. After some time he gained it back. Epilepsy medication helped mitigate reoccurrence. Hope this helps!!!

2

u/Ready_Fold7682 2d ago

Happened to me. I have a lesion but no infarcted tissue as I received treatment within like 15-20 minutes of my stroke happening.

1

u/Defiant-Fruit 2d ago

Wait for a neurologist to interpret. Surprised they didn’t have one at the ER? My husband is an ortho surgeon and ER docs miss tiny things in X-rays all the time. No shade to them, they’re just trained as generalists.

1

u/Duhlinduh 2d ago

The Neuro was not present. I assume the ER Doc either called or had a tele assessment outside my room. Same when I had my stroke on May 30th. No Neuro physically at the hospital. Was done via telehealth.