Koch Sebastian, Rabinstein Alejandro A, Romano Jose G, Forteza Alejandro
Department of Neurology, University of Miami School of Medicine, Professional Arts Center, FL 33136, USA.
Arch Neurol. 2004 Apr;61(4):510-2. doi: 10.1001/archneur.61.4.510.
Acute multiple brain infarction pattern on diffusion-weighted imaging is associated with arterial or cardiac sources of embolism.
To review the diffusion-weighted imaging characteristics of patients with strokes secondary to internal carotid artery (ICA) dissection and to gain further insights into the mechanisms of cerebral ischemia.
Patients with ICA dissection and ischemic stroke were identified by review of an angiographic database and hospital discharge codes. Patients were included if the diagnosis of ICA dissection was confirmed and diffusion-weighted imaging was obtained within 10 days of symptom onset. Infarct patterns were analyzed according to established templates of vascular territories.
Inclusion criteria were met by 14 patients. Internal carotid artery occlusion was present in 10. Acute multiple brain infarction was found in 10 (71%) of the 14 patients. Cortical involvement was found in 8 patients, while the infarct was restricted to the subcortical region in 6. In 9 (64%) of the 14 patients, ischemic lesions were located in 1 of the 3 border zones.
Acute multiple brain infarction pattern with border zone involvement is frequently found in ICA dissection-related strokes. This finding may further support an interaction of hemodynamic and embolic mechanisms as a cause of cerebral ischemia in this condition.
弥散加权成像上的急性多发性脑梗死模式与动脉或心脏来源的栓塞有关。
回顾颈内动脉（ICA）夹层所致卒中患者的弥散加权成像特征，并进一步深入了解脑缺血的机制。
通过查阅血管造影数据库和医院出院编码，确定ICA夹层和缺血性卒中患者。如果ICA夹层诊断得到证实且在症状发作后10天内获得弥散加权成像，则纳入患者。根据既定的血管区域模板分析梗死模式。
14例患者符合纳入标准。10例存在颈内动脉闭塞。14例患者中有10例（71%）发现急性多发性脑梗死。8例患者有皮质受累，而6例梗死局限于皮质下区域。14例患者中有9例（64%）缺血性病变位于3个边缘区中的1个。
在ICA夹层相关卒中中经常发现伴有边缘区受累的急性多发性脑梗死模式。这一发现可能进一步支持血流动力学和栓塞机制的相互作用是这种情况下脑缺血的原因。
