Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Mechanisms and clinical features of posterior border-zone infarcts
Autore:
Belden, JR; Caplan, LR; Pessin, MS; Kwan, E;
Indirizzi:
New England Med Ctr, Dept Neurol, Stroke Serv, Boston, MA 02111 USA New England Med Ctr Boston MA USA 02111 Stroke Serv, Boston, MA 02111 USA New England Med Ctr, Dept Radiol, Neuroradiol Sect, Boston, MA 02111 USA New England Med Ctr Boston MA USA 02111 radiol Sect, Boston, MA 02111 USA
Titolo Testata:
NEUROLOGY
fascicolo: 6, volume: 53, anno: 1999,
pagine: 1312 - 1318
SICI:
0028-3878(19991012)53:6<1312:MACFOP>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTERNAL CAROTID-ARTERY; MAJOR CEREBRAL-ARTERIES; WATERSHED INFARCTION; VARIABILITY; OCCLUSION; TERRITORIES; PATTERNS; STROKE; PATHOGENESIS; EMBOLISM;
Keywords:
border-zone cerebral infarct; cerebral embolism; carotid occlusion; carotid stenosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Belden, JR 49 Spring St, Scarborough, ME 04074 USA 49 Spring St Scarborough ME USA 04074 carborough, ME 04074 USA
Citazione:
J.R. Belden et al., "Mechanisms and clinical features of posterior border-zone infarcts", NEUROLOGY, 53(6), 1999, pp. 1312-1318

Abstract

Background: Previous studies link posterior border-zone cerebral infarcts between the middle cerebral artery (MCA) and the posterior cerebral artery (PCA) to hemodynamic causes, not embolism. Objective: To study the cause ofthese infarcts. Methods: We studied 21 patients (unilateral = 18, bilateral = 3) with acute, symptomatic posterior border-zone infarcts shown on CT or MRI to clarify stroke mechanisms. Patients were identified by review of CT and MRI logs and medical records during a 35-month period. An embolic mechanism was assigned when a source of embolism from either the heart, aorta,or parent large artery was present in the absence of intrinsic MCA or PCA disease. A hemodynamic mechanism was assigned when systemic hypotension waspresent. Results: Among patients with unilateral lesions, 10 were embolic (7 cardiac, 3 carotid). 7 were unknown, and one patient had vasospasm from a ruptured aneurysm. Visual field abnormalities predominated over motor, sensory, and language abnormalities. All patients with bilateral posterior border-zone lesions had perioperative hypotension. Prolonged lethargy, bilateral limb weakness, and cortical blindness were common. Conclusions: Embolism, either cardiac or from the parent carotid artery, is the predominant stroke mechanism in unilateral posterior border-zone infarcts, not distal field perfusion failure. Bilateral posterior border-zone infarcts have a distinctive clinical presentation and are caused by systemic hypotension. Variability of irrigation of the major arteries, passage of emboli to border-zone areas, and decreased clearance of emboli in these areas explain the findings in the patients with unilateral lesions.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 12:19:25