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[Bilateral multiple border zone infarctions after massive bleeding: report of two cases].

Akihiko Ueda1, Yoichiro Hashimoto, Fumihito Kugimiya

  • 1Department of Neurology, Kumamoto City Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|December 2, 2005
PubMed
Summary

Massive blood loss can cause anemic hypoxia, leading to bilateral brain infarctions. This study highlights border zone infarcts as a key indicator of global brain hypoperfusion due to severe anemia.

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Area of Science:

  • Neurology
  • Radiology
  • Hematology

Background:

  • Massive bleeding can lead to severe anemia and global hypoperfusion.
  • Anemic hypoxia is a critical condition affecting oxygen supply to the brain.

Observation:

  • Two patients presented with neurological deficits following significant blood loss.
  • Patient 1: 46-year-old female with visual disturbance and left hemiparesis post-menorrhagia.
  • Patient 2: 67-year-old male with altered consciousness and right hemiplegia post-GI bleed.

Findings:

  • Diffusion-weighted MRI revealed bilateral, multiple border zone infarcts in both cerebral and cerebellar hemispheres in both patients.
  • Brain MRA was normal in Patient 1; Patient 2 had an asymptomatic carotid artery occlusion.

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Implications:

  • Bilateral multiple border zone infarcts are indicative of anemic hypoxia.
  • Global brain hypoperfusion secondary to massive hemorrhage is a critical cause of ischemic brain injury.
  • Early recognition of these infarct patterns is crucial for managing patients with severe anemia and blood loss.