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Internal borderzone infarction in patients with ischemic stroke

C Gandolfo1, M Del Sette, C Finocchi

  • 1Stroke Unit, Department of Neurosciences and Neurorehabilitation, University of Genoa, Italy.

Cerebrovascular Diseases (Basel, Switzerland)
|September 17, 1998
PubMed
Summary

Pure internal borderzone infarcts are rare in stroke patients. Carotid stenosis or occlusion is a significant cause of these specific cerebral infarctions.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Cerebrovascular Disease

Background:

  • The etiology of cerebral infarction in the borderzone between deep and superficial perforating arteries remains unclear.
  • Subcortical infarcts in this specific borderzone area require further investigation.

Purpose of the Study:

  • To determine the prevalence, volume, location, and causes of internal borderzone subcortical infarction.
  • To investigate the etiological factors in a large cohort of unselected stroke patients.

Main Methods:

  • Analysis of 383 consecutive patients with recent cerebral infarction.
  • Comprehensive clinical and instrumental evaluation of all patients.
  • Statistical comparison of patients with isolated internal borderzone infarcts versus other infarct types.

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Main Results:

  • Internal borderzone infarcts constituted 12% of all ischemic lesions (90/725), with a median volume of 0.32 ml.
  • Isolated internal borderzone infarcts were found in only 3.4% of patients (13/383).
  • Carotid stenosis or occlusion was identified as a significant independent etiological factor for pure internal borderzone infarction.

Conclusions:

  • Isolated internal borderzone infarctions are uncommon in ischemic stroke patients.
  • Hemodynamic compromise from carotid artery stenosis or occlusion is the likely primary cause in most cases.