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Two CT patterns were identified:6 patients had confluent internal watershed infarction(CIWI),and 12 patients had partial internal watershed infarction(PIWI).Syncopal symptoms and/or documented hypotension were prominent in both groups.Patients with CIWI usually presented with stepwise onset of contralateral hemiplegia and recovered poorly;patients with PIWI usually had discrete episodes of brachiofacial sensorimotor deficit and good recovery.Both groups had evidence of cortical involvement as patient of their clinical deficit.Severe carotid occlusive disease was seen in 10 patients,and 12 patients had evidence of transiently impaired cardiac output.Carotid disease(P<.001),cardiac disease(P<.01),and diabetes mellitus(P<.01)were more prevalent in patients with internal watershed infarction compared with our stroke population as a whole.Distinguishing internal watershed infarction from lacunar and other subcortical infarctions is important because the different pathological mechanisms demand different therapeutic strategies. |
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border zone hypoperfusion
border zone infarct
carotid artery disease
carotid artery occlusion,neck
carotid artery stenosis
carotid artery stenosis,bilateral
CAT scan
CAT scan,abnormal
centrum semiovale
cerebral hypoperfusion
cerebrovascular accident
cerebrovascular accident,pathophysiology
corona radiata
hypotension,systemic
lacunar infarction,differential diagnosis of
neurologic signs
review article
risk factors
syncope
watershed infarcts
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