Mild neurological symptoms despite middle cerebral artery occlusion.

BACKGROUND AND PURPOSE Only a small percentage of stroke patients are treated with thrombolytic therapy. We sought to determine whether vessel occlusion in mild strokes represented a new target population for interventional therapy. METHODS We imaged 106 acute stroke patients with MRI. Patients were identified with evidence of middle cerebral artery (MCA) occlusion and mild or no stroke signs (National Institutes of Health Stroke Scale [NIHSS] 3, and MCA occlusion. RESULTS We identified 5 patients with absent flow on MRA in the MCA and mild or no stroke signs (NIHSS <or=3). All 5 were functionally independent at 3 months. CONCLUSIONS Caution should be exercised in considering thrombolytic therapy in these patients. Quantification of perfusion imaging is required to identify "at risk" mild stroke populations.