Lasting cytotoxic edema as an indicator of irreversible brain damage: a case of neonatal stroke

We describe a case of neonatal stroke in the territory of the left middle cerebral artery. Although the ischemic lesion appeared rather homogeneously hyperintense on T2-weighted MR images, corresponding diffusion-weighted images clearly delineated two separate zones of different cellular swelling and, thus, different prognoses. Lasting cytotoxic edema heralded infarction. We believe that the different rates of disintegration of neurons and glial cells may have caused the change from intracellular to interstitial volume fraction during the evolution of edema.