Etiologuc evaluation of anterior brain circulation internal and external watershed infacts

Abstract

Borderline infarcts (BZI) are ischemic lesions located at the junction between two arterial territories and account for about 10% of all brain infarcts.although imaging and pathological charactristics of this type of infarcts are known well but the the etiology is still under unvestigation.because the treatment of patients with cerebral infarction based on the pathophysiology of the lesion will be different and to select the best methodsin the treatment of these patients ,it is important to know the mechanisms that cause it. This study aimed to understand the cause of this type of cerebral infarction and, accordingly, making better decisions about treatment choices. Methods The present study is based on 106 patients with MRI confirmation of either cortical or subcortical Watershed infarcts .They were divided into 2 groups of external watershed and internal watershed infarct with 53 patient in every group.evaluation of patients with history,physical examination,vascular imaging study and cardiac study for finding of embolic source was performed. After performing diagnostic tests, the obtained etiologies were placed in TOAST(Trial of Org 10172 in Acute Stroke Treatment) classification. Results One hundred and six patients were enrolled: 32(60.3%) males and 21(39.7%) females in the external(cortical) watershed infarct group and 37(69.8%) males and 16(30.2%) females in the internal(subcortical) watershed infarct group. The results of this study showed that there is no correlation between the type of watershed infarcts and hemodynamic factors. LAA was the most common etiology of infarction in both groups. LAA in the internal watershed group was significantly higher than the other group.