Etiology and Risk Factors in Patients with Cortical Borderzone lnfarcts

Abstract

Background: Borderzone infarcts are ischemic lesions that develop on thenjunctional region of two main cerebral arteries. These lesions are divided in two groups as cortical and internal borderzone infarcts. Although factors causing hemodynamic failure such as severe carotis disease suggested in the etiopathogenesis of these lesions, cardiac and embolic mechanisms have been considered especially in cortical borderzone infarcts in recent years. In this report clinical, demographic, and etiologic features of cases with cortical borderzone infarcts were discussed in association with the literature. Objective: Files of the 20 patients with cortical borderzone in farcts between January 2000 and April 2003 were investigated retrospectively; age, sex, stroke risk factors, and etiologies according to the TOAST classification were registered. Findings: Of 20 patients 11 were male, and 9 were female; and mean age of them were 69.2±7.5 (55 - 87). The cases were classified according to the TOAST criteria and cardioembolism in 9 (% 45), large artery atherotrombosis in 4 (20 %) cases were detected. The etiology could not be found in 7 cases (35%). Conclusion: Cardioembolism was detected in major group of patients with cortical border zone infarcts in our study. We think that cardioembolism besidesclassical hemodynamic mechanism must be considered in these patients in the view of stroke etiology investigation, and secondary prophylaxis.