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A typical example of cerebral watershed infarct

Ina Juergenson, Sara Mazzucco, Michele Tinazzi
  • Ina Juergenson
    Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy | ina.juergenson@gmx.de
  • Sara Mazzucco
    Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy
  • Michele Tinazzi
    Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy

Abstract

Watershed infarcts (WI) evolve in hemodynamic risk zones. Clinical picture of WI can be associated to partial epileptic seizures. Diffusion weighted brain magnetic resonance imaging (MRI) allows a clear diagnosis. WI pathogenesis involves either embolic or hemodynamic mechanism. A 69-year old patient presented with sub-acute occurrence of right hemiparesis and partial epileptic seizures of the right arm. Carotid ultrasounds demonstrated occlusion of the right extra-cranial internal carotid artery (ICA) and tight stenosis of the contralateral ICA. Brain Diffusion-Weighted magnetic resonance revealed acute ischemic lesions within the watershed area of the left hemisphere. Our case supports the hypothesis of impaired washout of emboli in low-perfusion brain areas as the mechanism underlying cortical WI.

Keywords

watershed infarct, carotid atherosclerosis, carotid ultrasounds, Diffusion-Weighted Magnetic Resonance.

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Submitted: 2011-10-21 18:18:14
Published: 2011-11-18 18:54:17
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Copyright (c) 2011 Ina Juergenson, Sara Mazzucco, Michele Tinazzi

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