Association of internal border zone infarction with middle cerebral artery steno-occlusion.
BACKGROUND
Demonstrating the precise anatomical area of the internal border zone (IB) by brain imaging has been unclear, and it is not well known which relevant arteries are associated with IB infarction.


METHODS
Patients with IB infarctions were selected from 748 consecutive patients with acute ischemic stroke. The IB infarctions were identified by coronal diffusion-weighted imaging, excluding lesions over the upper pole of the lateral ventricle. The angiographic findings of the internal carotid artery (ICA) and middle cerebral artery (MCA), on contrast-enhanced MRA, were evaluated in the patients with and without IB infarction.


RESULTS
Thirty patients met the criteria for an IB infarction: 7 had MCA steno-occlusion without ICA disease, and 23 had ICA steno-occlusion. Sixty-one patients had ICA steno-occlusion without IB infarction. The multiple logistic regression analysis showed that a more than moderate degree of steno-occlusion of the MCA was a significant factor (OR, 11.32; p = 0.006) associated with IB infarction; whereas that of the ICA was not significant (OR, 2.19; p = 0.298).


CONCLUSIONS
The results of this study suggest that IB infarctions were associated with MCA steno-occlusion. ICA disease resulting in IB infarctions would be expected to have significant MCA steno-occlusion causing hemodynamic compromise.
Kim
Doh-Eui
DE
Department of Neurology, Soonchunhyang University, College of Medicine, Seoul, Korea.
Lee
Kyung-Bok
KB
Roh
Hakjae
H
Ahn
Moo-Young
MY
Roh
Jae-Kyu
JK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000150:complications* / Q000473:pathology*; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors