Clinical Profiles of Borderzone Infarction

J Korean Neurol Assoc > Volume 14(3); 1996 > Article

Journal of the Korean Neurological Association 1996;14(3): 704-709.

한시령, 나정호, 김범생

카톨릭대학 신경과

Clinical Profiles of Borderzone Infarction

Si-Ryung Han M.D., Joung-Ho Rha M.D., Beum-saeng Kim M.D.

Department of Neurology, St. Mary's Hospital, Catholic University Medical College

Abstract

Background & Objectives : Borderzone(BZ) infarcts located between two main arterial territories can be classified into several subtypes . Anterior and posterior BZ and internal junctional infarcts. We performed this study to describe the different clinical features between each subtypes. Method : Thirty-five (29 men, 6 women) acute stroke patients whose brain imaging (CT/MRI) showed BZ infarcts were included in this study. BZ infarcts were classified into three types : anterior and posterior BZ and internal junctional infarct. And we tried to describe different clinical features such as mode of onset, positive neurologic findings, and neuroanatomical correlation with clinical manifestations. Result : All BZ infarcts were 51. Anterior 9(18%), posterior 23(45%); and internal junctional 19 (37%). Most common type were posterior BZ and internal junctional infarct alone (11 each). Twenty-eight (80%) patients presented the symptoms correlated with BZ infarct. Asymptomatic patients whose symptom was not correlated with BZ infarct were 7(20%). Clinicoradiologic classification in symptomatic group were reclassified into P'(posterior BZ) in 16 (57%) ; I'(internal junctional BZ) in 8(29%) , N(not classified) in 4. None was included to A'(anterior BZ). We could not find any different clinical features according to each subtype but only the group P' characteristically showed transient loss of consciousness, Gerstman syndrome, hemianopsia, and limb shaking. Conclusion : Most frequently involved areas were posterior BZ and internal junctional infarct alone. In follow-up of combined anterior and posterior BZ infarct, posterior almost always preceded anterior. The patients with symptoms correlated with radiological localization of BZ infarct is 80%. Fifty percent of them had acute onset. In pure internal junctional infarct, 45 % showed symptoms not correlated with radiological localization. None had the anterior BZ symptomatology.