Document Detail

Border zone infarcts: pathophysiologic and imaging characteristics.
MedLine Citation:
PMID:  21918038     Owner:  NLM     Status:  In-Data-Review    
Border zone or watershed infarcts are ischemic lesions that occur in characteristic locations at the junction between two main arterial territories. These lesions constitute approximately 10% of all brain infarcts and are well described in the literature. Their pathophysiology has not yet been fully elucidated, but a commonly accepted hypothesis holds that decreased perfusion in the distal regions of the vascular territories leaves them vulnerable to infarction. Two types of border zone infarcts are recognized: external (cortical) and internal (subcortical). To select the most appropriate methods for managing these infarcts, it is important to understand the underlying causal mechanisms. Internal border zone infarcts are caused mainly by hemodynamic compromise, whereas external border zone infarcts are believed to result from embolism but not always with associated hypoperfusion. Various imaging modalities have been used to determine the presence and extent of hemodynamic compromise or misery perfusion in association with border zone infarcts, and some findings (eg, multiple small internal infarcts) have proved to be independent predictors of subsequent ischemic stroke. A combination of several advanced techniques (eg, diffusion and perfusion magnetic resonance imaging and computed tomography, positron emission tomography, transcranial Doppler ultrasonography) can be useful for identifying the pathophysiologic process, making an early clinical diagnosis, guiding management, and predicting the outcome. © RSNA, 2011.
Rajiv Mangla; Balasubramanya Kolar; Jeevak Almast; Sven E Ekholm
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiographics : a review publication of the Radiological Society of North America, Inc     Volume:  31     ISSN:  1527-1323     ISO Abbreviation:  Radiographics     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-09-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8302501     Medline TA:  Radiographics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1201-14     Citation Subset:  IM    
Department of Imaging Sciences, University of Rochester, School of Medicine and Dentistry, 601 Elmwood Ave, PO Box 648, Rochester, NY 14642-8648.
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