DWI-FLAIR Mismatch in Stroke: “P.S.” (Partial Strategic Concept) for Clinical Practice

Recent studies have shown that diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) MRI (DWI-FLAIR) mismatch is useful for thrombolytic treatment decisions in acute ischemic stroke. However, the role of partial mismatch in strategic locations among patients with evolving stroke has not been described before. Partial imaging mismatch involving strategic locations might indicate reversible ischemia, enabling thrombolysis even in those patients presenting in the extended time windows. In this report, we describe the partial strategic concept of DWI-FLAIR mismatch with case examples.