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Cortical border-zone infarcts: clinical features, causes and outcome.
MedLine Citation:
PMID:  22696583     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ObjectiveTo report the clinical features, causes and outcome of cerebral cortical border-zone infarcts BZI (C-BZI).MethodsThe authors prospectively included patients with MRI-confirmed C-BZI among individuals consecutively admitted in Stroke Unit.ResultsForty-five patients presented C-BZI out of 589 with MRI-confirmed cerebral infarcts (7.6%). Particular clinical characteristics existed in C-BZI in comparison with other cerebral infarctions as a whole, including: (1) frequent transient symptoms at onset (27% vs 9%; p<0.001) and low severity score (NIHSS=3.1±3.0 vs 5.2±6.1; p=0.02); (2) early seizures in first 2 weeks (7/45 (15.6%) vs 12/544 (2.2%); p<0.001), even when focusing only on other infarctions involving the cerebral cortex (15.6% vs 4.3%; p<0.01); (3) heterogeneous clinical presentation but specific transcortical aphasia allowing a clinical suspicion of BZI before MRI; and (4) frequently associated internal carotid disease (69%), with subsequent early surgery in 75% of the cases. Following adapted care in stroke unit, C-BZIs' prognosis appeared good (Rankin score ≤2 at D90) for 82% of the patients.ConclusionSome clinical features are overrepresented in such infarctions, including initial transient symptoms preceding the onset of a completed deficit, transcortical aphasia and early seizures. Despite lower initial severity, C-BZIs justify early management in stroke unit, often followed by carotid surgery, leading to an overall good prognosis.
Authors:
Claire Joinlambert; Guillaume Saliou; Constance Flamand-Roze; Pascal Masnou; Mariana Sarov; Raphaelle Souillard; Marie Saliou-Théaudin; Thierry Guedj; Patrick Assayag; Denis Ducreux; David Adams; Christian Denier
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-13
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  -     ISSN:  1468-330X     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neurology, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France.
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