Watershed zone cerebral infarction

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Sudden onset of left-sided weakness.

Patient Data

Age: 65 years
Gender: Female

Watershed infarcts in the right subcortical and centrum semiovale white matter as evidenced by abnormal diffusion restriction on DWI at the border zones of the middle cerebral artery/anterior cerebral artery (MCA/ACA) and middle cerebral artery/posterior cerebral artery (MCA/PCA) territories.

Foci of abnormal signal in the left frontal lobe subcortical white matter suggest microvascular ischemic events.

Case Discussion

Watershed cerebral infarction, also known as border zone infarct, occurs at the border between cerebral vascular territories where the tissue is furthest from arterial supply and thus most vulnerable to reductions in perfusion.

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