title: Internal border zone lesions as a predictor of early neurological deterioration in minor stroke patients with severe arterial steno-occlusion.
abstract: BACKGROUND
  Early neurological deterioration (END) of acute ischemic stroke may be important because it can predict clinical outcomes. We described several cases with similar clinical findings but different outcomes and analyzed the characteristics of their imaging studies. We retrospectively analyzed minor stroke patients with severe arterial stenosis within 6 hours of stroke onset. We defined END as 4 or more deterioration of the National Institutes of Health Stroke Scale score. Diffusion-weighted imaging (DWI) lesions were classified as lesions of the pial artery (PI), perforating artery (PAI) and border-zone (BZ).
  
  
  RESULTS
  We consecutively analyzed a total of 12 subjects in this study. The patterns of initial DWI lesions were internal BZ (50%), PI (50%), PAI (25%), and cortical BZ (16.7%). Among them, the number of subjects with END was 5, and the frequency of internal BZ on initial DWI was significantly higher in patients with END than in those without.
  
  
  CONCLUSIONS
  In conclusion, the results of this study suggest that when internal BZ infarcts are detected in patients with acute minor strokes accompanied by severe arterial stenosis, close observation and careful management should be performed because END can be induced at an early stage.
authors.affiliation: Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Joon-Tae
authors.initials: JT
authors.lastname: Kim
authors.forename: Geum-Jin
authors.initials: GJ
authors.lastname: Yoon
authors.forename: Tai-Seung
authors.initials: TS
authors.lastname: Nam
authors.forename: Seong-Min
authors.initials: SM
authors.lastname: Choi
authors.forename: Seung-Han
authors.initials: SH
authors.lastname: Lee
authors.forename: Man-Seok
authors.initials: MS
authors.lastname: Park
authors.forename: Byeong-Chae
authors.initials: BC
authors.lastname: Kim
authors.forename: Myeong-Kyu
authors.initials: MK
authors.lastname: Kim
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Cho
mesh_terms: D000328:Adult; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications* / Q000175:diagnosis*; D020762:Infarction, Posterior Cerebral Artery / Q000150:complications* / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology*; D014057:Tomography, X-Ray Computed