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- Vol.45 No.10
- CLINICA NEUROL, 45: 724－729, 2005
- Vol.45 No.10 contents
Case Report
Bilateral multiple border zone infarctions after massive bleeding: Report of two cases
Akihiko Ueda, M.D.1), Yoichiro Hashimoto, M.D.1), Fumihito Kugimiya, M.D.2), Kiminobu Yonemura, M.D.2), Teruyuki Hirano, M.D.3) and Makoto Uchino, M.D.3)
1)Department of Neurology, and
2)Department of Strokology, Kumamoto City Hospital
3)Department of Neurology, Graduate School of Medical Sciences, Kumamoto University
We present two patients who developed bilateral border zone brain infarctions after massive bleeding.
Patient 1 was a 46-year old woman who developed bilateral visual disturbance and left hand monoparesis after excessive menstruation with severe anemia. Diffusion-weighted MRI of brain showed multiple border zone infarcts bilaterally in cerebral and cerebellar hemispheres while brain MRA was normal.
Patient 2 was a 67-year old man who developed disturbance of consciousness and right hemiplegia after upper gastrointestinal tract bleeding. Diffusion-weighted MRI of brain showed bilateral multiple border zone infarcts in cerebral hemispheres, although he had asymptomatic occlusion of the left internal carotid artery.
The bilateral multiple border zone infarcts are one of the key findings suggesting the presence of anemic hypoxia as a result of global brain hypoperfusion caused by massive blood loss.
(CLINICA NEUROL, 45: 724－729, 2005)
key words: bilateral border zone brain infarction, massive bleeding, hemodynamic infarction, optico-cerebral syndrome, diffusion-weighted MRI
(Received: 22-Nov-04)
