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Chakraborty D. Border-Zone Infarcts and the Inside Story! Ann Indian Acad Neurol 2023; 26:624-625. [PMID: 38022481 PMCID: PMC10666885 DOI: 10.4103/aian.aian_542_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Debabrata Chakraborty
- Department of Neurology, Apollo Multispeciality Hospitals, Kolkata, West Bengal, India
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Hamdy S, Fathy M, Elnasser AA, Darwish EAF, Hamid E, Aref H, El Nahas N. Vasomotor reactivity in patients with cerebral small vessel disease vs. internal border zone infarction and its correlation with disease outcome. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00537-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Available data collected from patients of different types of cerebrovascular strokes can detect risk factors, severity and clinical outcome of these patients. Differentiating between different types of strokes is mandatory for early diagnosis and proper management. The aim of this study is to compare between cerebral small vessel disease with lacunar infarctions and internal border zone infarctions regarding vasomotor reactivity by using transcranial color-coded duplex and its correlation with their MRI perfusion, disease severity and outcome.
Results
On admission, 56.7% of patients in lacunar stroke had impaired reactivity vs. 100% of patients in internal border zone group. At 3 months follow-up, this number dropped to 23.3% in lacunar group, but persisted as 100% in internal border zone group. On comparing the 3 perfusion parameters between the 2 groups, there was statistically significant impairment in all parameters in patients with internal border zone infarction than patients with lacunar infarction (longer time to peak, decreased cerebral blood flow and cerebral blood volume). By comparing the severity of the stroke by using National Institute of Health and Stroke Scale, it was found that patients with internal border zone infarction had higher disability than patients with lacunar infarction on admission and on discharge. At 3 months follow-up, the lacunar group had a better outcome than of the border zone group.
Conclusion
Patients having internal border zone infarction had higher clinical disability and worse prognosis, together with more impairment in vasomotor reactivity and MRI perfusion parameters than patients having lacunar infarction.
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