Article Text

Download PDFPDF
Research paper
Cortical border-zone infarcts: clinical features, causes and outcome


Objective To report the clinical features, causes and outcome of cerebral cortical border-zone infarcts BZI (C-BZI).

Methods The authors prospectively included patients with MRI-confirmed C-BZI among individuals consecutively admitted in Stroke Unit.

Results Forty-five patients presented C-BZI out of 589 with MRI-confirmed cerebral infarcts (7.6%). Particular clinical characteristics existed in C-BZI in comparison with other cerebral infarctions as a whole, including: (1) frequent transient symptoms at onset (27% vs 9%; p<0.001) and low severity score (NIHSS=3.1±3.0 vs 5.2±6.1; p=0.02); (2) early seizures in first 2 weeks (7/45 (15.6%) vs 12/544 (2.2%); p<0.001), even when focusing only on other infarctions involving the cerebral cortex (15.6% vs 4.3%; p<0.01); (3) heterogeneous clinical presentation but specific transcortical aphasia allowing a clinical suspicion of BZI before MRI; and (4) frequently associated internal carotid disease (69%), with subsequent early surgery in 75% of the cases. Following adapted care in stroke unit, C-BZIs' prognosis appeared good (Rankin score ≤2 at D90) for 82% of the patients.

Conclusion Some clinical features are overrepresented in such infarctions, including initial transient symptoms preceding the onset of a completed deficit, transcortical aphasia and early seizures. Despite lower initial severity, C-BZIs justify early management in stroke unit, often followed by carotid surgery, leading to an overall good prognosis.

  • Watershed infarct
  • border-zone
  • transient ischaemic attack
  • endarterectomy
  • early seizures
  • transcortical mixt aphasia
  • carotid stenosis
  • prognosis
  • aphasia
  • cerebrovascular disease
  • movement disorders
  • dysphagia
  • metabolic disease
  • stroke
  • multiple sclerosis
  • cardiology
  • amyloid
  • neuropathy
  • peripheral neuropathology
  • paraproteinaemia

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.