Internal watershed zone cerebral infarction

Case contributed by Dr Dalia Ibrahim


Sudden onset of left sided weakness.

Patient Data

Age: Elderly
Gender: Male

Multiple right cerebral internal border zone infarcts showing restricted diffusion. Absent flow void within the right ICA suggesting occlusion. 

MRA: occlusion of the right internal carotid artery.

Case Discussion

The internal border zone infarctions are located in the deep white matter of the centrum semiovale and corona radiata at the border zone of the lenticulostriate perforators and the deep penterating cortical branches of the MCA or at the border zone of the deep white matter branches of the MCA & the ACA.

This pattern of deep watershed infarctions is quite common and should urge you to examine the carotids.

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Case information

rID: 27611
Published: 10th Feb 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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