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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Cortical border-zone infarcts: clinical features, causes and outcome
Claire Joinlambert1, Guillaume Saliou, Constance Flamand-Roze
1Department of Neurology, Bicêtre Hospital, Assistance Publique – Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France.
Journal of Neurology, Neurosurgery, and Psychiatry
|June 15, 2012
Summary
Cerebral cortical border-zone infarcts (C-BZIs) present unique features like transient symptoms and early seizures. Prompt stroke unit management and potential carotid surgery lead to a good prognosis for most patients with C-BZIs.
Area of Science:
- Neurology
- Cerebrovascular Diseases
- Neuroimaging
Background:
- Cerebral cortical border-zone infarcts (C-BZIs) are a specific type of ischemic stroke.
- Understanding their clinical presentation, etiology, and outcomes is crucial for effective patient management.
Purpose of the Study:
- To detail the clinical characteristics, causes, and prognosis of C-BZIs.
- To identify specific features that may aid in the pre-imaging diagnosis of C-BZIs.
Main Methods:
- Prospective study of patients admitted to a Stroke Unit.
- MRI confirmation of C-BZIs in a cohort of stroke patients.
- Comparison of clinical features between C-BZI patients and those with other cerebral infarcts.
Main Results:
- C-BZIs occurred in 7.6% of MRI-confirmed cerebral infarcts.
- C-BZI patients exhibited more transient onset symptoms (27%) and lower initial NIHSS scores compared to other infarcts.
- Early seizures (15.6%) and transcortical aphasia were more frequent in C-BZIs.
- Internal carotid artery disease was common (69%), leading to surgery in 75% of affected cases.
- 82% of C-BZI patients had a good outcome (Rankin score ≤2 at 90 days).
Conclusions:
- Transient symptoms, transcortical aphasia, and early seizures are characteristic of C-BZIs.
- Despite lower initial severity, C-BZIs require prompt stroke unit care and often carotid intervention.
- Early management of C-BZIs is associated with a favorable prognosis.
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