Document Detail


Internal and cortical border-zone infarction: clinical and diffusion-weighted imaging features.
MedLine Citation:
PMID:  16424374     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The pathogenesis of internal border-zone (IBZ) and cortical border-zone (CBZ) infarcts is unclear. Both types of infarct have been combined into a single group in most previous reports, which has produced conflicting results. We hypothesized that different pathogenic mechanisms underlie IBZ and CBZ infarcts. METHODS: We reviewed 946 consecutive patients with ischemic stroke within the middle cerebral artery territory. IBZ and CBZ infarcts were selected based on diffusion-weighted imaging templates to identify vascular territories. Baseline patient characteristics, clinical courses, and neuroradiological features were compared between patients with IBZ and CBZ infarcts. RESULTS: We identified 45 IBZ and 75 CBZ infarct patients. Compared with the CBZ infarct patients, IBZ infarct patients had a higher degree of stenosis or occlusion in either the middle cerebral or internal carotid artery (P=0.008) and exhibited a rosary-like pattern of infarction more frequently (P<0.001). In contrast, concomitant small cortical infarcts were observed more frequently in CBZ infarct patients (P<0.001). Clinical deterioration during the first 7 days of admission and poor outcome after 3 months after stroke was more prevalent in IBZ infarct patients than in CBZ infarct patients (P=0.002 and P=0.003, respectively). CONCLUSIONS: IBZ infarcts are caused mainly by hemodynamic compromise, whereas embolic pathogenesis appears to contribute greatly to the genesis of CBZ infarcts. Patients with IBZ infarcts showed poor early and late clinical courses. Our findings suggest that different therapeutic approaches may be required to prevent early clinical deterioration in patients with different types of border-zone infarcts.
Authors:
Seok Woo Yong; Oh Young Bang; Phil Hyu Lee; Wen Yu Li
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-01-19
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  37     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-28     Completed Date:  2006-03-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  841-6     Citation Subset:  IM    
Affiliation:
Department of Neurology, School of Medicine, Ajou University, Suwon, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain / anatomy & histology,  pathology
Brain Ischemia / pathology
Carotid Artery, Internal / pathology
Cerebral Infarction
Diffusion Magnetic Resonance Imaging / methods*
Female
Hemodynamics
Humans
Image Processing, Computer-Assisted / methods
Infarction, Middle Cerebral Artery / diagnosis,  pathology*
Male
Middle Aged
Multivariate Analysis
Regression Analysis
Risk
Time Factors
Comments/Corrections
Comment In:
Stroke. 2006 Nov;37(11):2658; author reply 2659   [PMID:  16990572 ]

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