ElSadek Ahmed, Gaber Ahmed, Afifi Hossam, Farag Sherin, Salaheldien Nouran
Ainshams University, P.O. 11681, Elrehab City, Cairo Egypt.
Egypt J Neurol Psychiatr Neurosurg. 2019;55(1):2. doi: 10.1186/s41983-018-0045-8. Epub 2019 Jan 6.
Brain perfusion is most likely to be impaired in border zone regions, and clearance of emboli will be most impaired in these regions of least blood flow. Severe occlusive disease of the internal carotid artery causes both embolization and decreased perfusion as well as some cardiac diseases that cause microembolization.
To differentiate between hypoperfusion and microemboli as etiology of acute ischemic stroke in watershed zone.
Fifty patients of acute ischemic stroke in watershed zones were recruited within 7 days from stroke onset. Methods used were transcranial Doppler (TCD) monitoring for the intracranial vessels to detect microembolic signals and magnetic resonance imaging (MRI) perfusion image to detect hypoperfusion signs.
We detect embolic causes of watershed infarction (WSI) by using TCD with 61.1% sensitivity and 84.4% specificity and hypoperfusion causes of WSI by using MRI perfusion studies with 94.9% sensitivity and 54.5% specificity.
We detected the etiology of WSI, either embolic by using TCD or hypoperfusion by using MRI perfusion. The embolic causes of WSI usually cause external or mixed WSI, and hypoperfusion causes of WSI cause internal WSI.
脑灌注最有可能在边缘区受损，而在这些血流最少的区域，栓子清除功能将受到最大程度的损害。颈内动脉的严重闭塞性疾病会导致栓塞、灌注减少，一些心脏疾病也会导致微栓塞。
区分分水岭区急性缺血性卒中的病因是灌注不足还是微栓子。
招募50例发病7天内的分水岭区急性缺血性卒中患者。采用的方法是经颅多普勒（TCD）监测颅内血管以检测微栓子信号，以及磁共振成像（MRI）灌注成像以检测灌注不足征象。
我们通过TCD检测分水岭梗死（WSI）的栓子病因，敏感性为61.1%，特异性为84.4%；通过MRI灌注研究检测WSI的灌注不足病因，敏感性为94.9%，特异性为54.5%。
我们检测到了WSI的病因，通过TCD检测到栓子病因，通过MRI灌注检测到灌注不足病因。WSI的栓子病因通常导致外侧或混合型WSI，而WSI的灌注不足病因导致内侧WSI。
