title: [Bilateral multiple border zone infarctions after massive bleeding: report of two cases].
abstract: We present two patients who developed bilateral border zone brain infarctions after massive bleeding. Patient 1 was a 46-year old woman who developed bilateral visual disturbance and left hand monoparesis after excessive menstruation with severe anemia. Diffusion-weighted MRI of brain showed multiple border zone infarcts bilaterally in cerebral and cerebellar hemispheres while brain MRA was normal. Patient 2 was a 67-year old man who developed disturbance of consciousness and right hemiplegia after upper gastrointestinal tract bleeding. Diffusion-weighted MRI of brain showed bilateral multiple border zone infarcts in cerebral hemispheres, although he had asymptomatic occlusion of the left internal carotid artery. The bilateral multiple border zone infarcts are one of the key findings suggesting the presence of anemic hypoxia as a result of global brain hypoperfusion caused by massive blood loss.
authors.affiliation: Department of Neurology, Kumamoto City Hospital.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ueda
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Fumihito
authors.initials: F
authors.lastname: Kugimiya
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Yonemura
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Hirano
authors.forename: Makoto
authors.initials: M
authors.lastname: Uchino
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D000983:Antipyrine / Q000031:analogs & derivatives / Q000627:therapeutic use; D020520:Brain Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D038524:Diffusion Magnetic Resonance Imaging; D000077553:Edaravone; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008595:Menorrhagia / Q000150:complications*; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000150:complications*; D013276:Stomach Ulcer / Q000150:complications*
chemical_list: D000925:Anticoagulants; D006454:Hemoglobins; D006493:Heparin; D000077553:Edaravone; D000983:Antipyrine