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Published on: July 31, 2014
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A typical example of cerebral watershed infarct
Ina Juergenson1, Sara Mazzucco1, Michele Tinazzi1
1Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy.
Clinics and Practice
|April 26, 2014
Summary
Watershed infarcts (WI) can cause partial epileptic seizures. Impaired emboli washout in low-perfusion brain areas may explain these hemodynamic risk zone events.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Neurology
Background:
- Watershed infarcts (WI) are ischemic brain lesions occurring in hemodynamic risk zones.
- Clinical presentation of WI can include partial epileptic seizures.
- Diffusion-weighted magnetic resonance imaging (MRI) is crucial for diagnosing WI.
Observation:
- A 69-year-old patient presented with right-sided hemiparesis and partial epileptic seizures affecting the right arm.
- Carotid ultrasound revealed complete occlusion of the right internal carotid artery (ICA) and significant stenosis of the left ICA.
- Brain MRI demonstrated acute ischemic lesions in the watershed areas of the left hemisphere.
Findings:
- The case illustrates a potential mechanism for cortical watershed infarcts.
- The findings support the hypothesis that impaired emboli washout in hypoperfused brain regions contributes to WI pathogenesis.
- This suggests a hemodynamic mechanism involving compromised cerebral blood flow.
Implications:
- Understanding WI pathogenesis is vital for stroke prevention and treatment.
- This case highlights the importance of evaluating carotid artery status in patients with specific neurological deficits.
- Further research into emboli dynamics in low-perfusion states is warranted.
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