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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping

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Published on: September 25, 2019

Border zone infarcts: pathophysiologic and imaging characteristics.

Rajiv Mangla¹, Balasubramanya Kolar, Jeevak Almast

¹Department of Imaging Sciences, University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642-8648, USA. manglarajiv@yahoo.com

Radiographics : a Review Publication of the Radiological Society of North America, Inc

|September 16, 2011

Summary

This summary is machine-generated.

Border zone infarcts, affecting 10% of brain infarcts, occur at arterial junctions. Understanding their distinct causes—hemodynamic compromise for internal and embolism for external infarcts—is key for effective management.

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Published on: October 23, 2020

Area of Science:

Neurology
Vascular Neurology
Neuroimaging

Background:

Border zone (watershed) infarcts are ischemic lesions at arterial territory junctions, representing ~10% of all brain infarcts.
Pathophysiology involves decreased perfusion, leaving distal vascular regions vulnerable.
Two types exist: external (cortical) and internal (subcortical) border zone infarcts.

Purpose of the Study:

To elucidate the underlying causal mechanisms of internal and external border zone infarcts.
To highlight the importance of understanding infarct type for appropriate management.
To review advanced imaging techniques for diagnosis and outcome prediction.

Main Methods:

Review of existing literature on border zone infarcts.
Discussion of various imaging modalities (MRI, CT, PET, TCD) for assessing hemodynamic compromise and perfusion.
Analysis of specific imaging findings as predictors of subsequent ischemic stroke.

Main Results:

Internal border zone infarcts are primarily caused by hemodynamic compromise.
External border zone infarcts are mainly attributed to embolism, though hypoperfusion may also contribute.
Specific findings like multiple small internal infarcts predict future ischemic stroke.

Conclusions:

Differentiating infarct types is crucial for guiding management strategies.
Advanced neuroimaging techniques are vital for identifying pathophysiology, enabling early diagnosis, and predicting outcomes.
A comprehensive approach combining multiple imaging modalities improves patient care for border zone infarcts.