String of pearls sign (watershed infarction)

Last revised by Frank Gaillard on 8 Mar 2021

The string of pearls sign is seen on diffusion-weighted imaging of T2/FLAIR as a series of rounded areas of signal abnormality adjacent to, but separate from, the lateral ventricle. This represents a deep border zone infarct between the penetrating cortical arteries and ascending perforating arteries 1

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Cases and figures

  • Case 1
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