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Updated: Oct 23, 2025
A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage
Published on: July 28, 2018
Voxel-based map of the inter-arterial watershed zones in children
Christian A Barrera1, Anith Chacko2, Fabrício Guimarães Gonçalves1
1Department of Radiology, Children's Hospital of Philadelphia, USA.
Insights
This study maps brain lesions in children with watershed hypoxic-ischemic injury, defining three distinct affected zones: anterior, peri-Sylvian, and posterior. This provides a detailed understanding of injury patterns in this vulnerable population.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Brain Injury Research
Background:
- Hypoxic-ischemic (HI) injury in newborns can affect the watershed regions of the brain.
- Understanding the precise location and extent of these injuries is crucial for diagnosis and treatment.
- Previous studies have not comprehensively mapped these specific injury patterns in children.
Purpose of the Study:
- To create a detailed voxel-based map of the inter-arterial watershed region in children who experienced a term hypoxic-ischemic injury.
- To identify and delineate the specific areas within the cortical watershed most frequently affected by HI injury.
Main Methods:
- Included patients aged 0-18 years with diagnosed watershed HI injury on MRI.
- Two pediatric neuroradiologists segmented lesion areas on T2-weighted MRI sequences.
- Normalized lesion maps were overlapped to generate a frequency map of cortical watershed involvement.
Main Results:
- A total of 47 children (35 boys) were analyzed, with a mean age of 7.6 years.
- The study successfully mapped the cortical watershed, defining three zones: anterior, peri-Sylvian, and posterior.
- Connectivity between zones was identified via specific gyri, with temporal and orbital frontal lobes largely spared.
Conclusions:
- A voxel-based lesion map for childhood watershed HI injury was successfully created.
- Three distinct inter-arterial watershed zones were defined: anterior, peri-Sylvian, and posterior.
- This mapping provides a clearer understanding of the anatomical distribution of HI injuries in the cortical watershed.
Purpose:
To create a voxel-based map of the inter-arterial watershed derived from children who have sustained a hypoxic-ischemic injury involving this region at term.
Materials And Methods:
Patients 0-18 years of age diagnosed with a hypoxic-ischemic injury of the watershed on magnetic resonance imaging (MRI) were included. Two pediatric neuroradiologists segmented the lesions as visualized on the T2-weighted sequence. All lesion maps were normalized to a brain template and overlapped to create a frequency map in order to highlight the frequency of involvement of portions of the cortical watershed.
Results:
A total of 47 patients (35 boys) were included in the final sample. Their mean age was 7.6 ± 3.6 years. The cortical watershed was successfully mapped. Three watershed regions were defined: the anterior, peri-Sylvian, and posterior watershed zones. The anterior and peri-Sylvian watershed zones are connected through the involvement of the middle frontal gyrus. The peri-Sylvian and the posterior watershed zones are connected through the involvement of the inferior parietal lobule, the posterior aspect of the superior temporal gyrus, and the angular gyrus with the occipital lobe. The temporal lobe and orbital part of the frontal lobe are largely spared in all patients.
Conclusion:
A voxel-based lesion map of children with watershed hypoxic ischemic injury at term was created and three inter-arterial watershed zones defined: anterior, peri-Sylvian, and posterior watersheds.
