Effects of cerebrovascular reserve on progress and outcome in patients with internal border zone infarction induced by severe middle cerebral artery stenosis / 临床神经病学杂志

Objective To assess cerebrovascular reserve ( CVR) function in patients with internal border zone infarction(IBZI) induced by severe middle cerebral artery (MCA) stenosis, and investigate the impact on progression and outcome of the disease .Methods A total of 84 patients with unilateral severe MCA stenosis were selected . Hypercapnia was induced by holding breath .The change of blood flow velocity in MCA was measured by transcranial Doppler ( TCD ) to calculate CVR .According to CVR , patients were divided into impaired regional CVR group ( CVR 0.05 ) .Conclusion Impaired regional CVR may be predictive of subsequent progressive cerebral infarction and poor clinical outcomes in patients with IBZI induced by severe MCA stenosis .

A Patient of Border-zone Infarction Caused by Defecation Syncope

A severe or prolonged drop in blood pressure caused by syncope can lead to border-zone infarction in the absence of coexisting large artery disease. Syncope due to defecation represent special cases of reflex syncope for which the mechanisms are poorly understood and probably multifactorial. We experienced a 56-year-old woman was recurrent loss of consciousness duration defecation. Brain MRI revealed multifocal high signals in T2WI and FLAIR image on both end-artery border zone, but brain MRA revealed normal finding. Thus, We report a rare case of an old woman patient with end-artery border zone infarction due to prolonged hypoperfusion that was caused by defecation syncope.

The relationship between cerebral border zone infarction and cerebral artery stenosis or occlusion / 临床神经病学杂志

Objective To observe the relationship between cerebral border zone infarction and cerebral artery stenosis or occlusion.Methods 45 patients admitted to our hospital in 2002 were studied retrospectively.They were diagnosied as acute cerebral border zone infarction and classified into anterior border infartion,posterior border infartion and internal border infartion by diffusion weighted MR imaging(DWI). The stenosis or occlusion of cerebral arteries was evaluated by magnetic resonance angiography(MRA) or transcranial doppler(TCD) examinations.Results Cerebral artery stenosis or occlusion was founded in 32 patients(71.1%).The lesions were most located in middle cerebral artery(47.6%),next in internal carotid artery(31%), relatively seldom in anterior cerebral artery and posterior cerebral artery(11.9%). No difference of artery abnormity was found between the patients with single border infarction and the patients with mutiple border infarction.But middle cerebral artery stenosis was more frequently seen in the patients with internal border infartion( P