Mechanisms and clinical features of internal watershed infarction.

Abstract

The mechanism of internal carotid watershed cerebral infarction is not well understood, but the phenomenon has been described in association with carotid occlusive disease, and more recently with distal middle cerebral artery occlusion beyond the origin of the lenticulostriate branches. The clinical correlates of these changes have not yet been described. We present 5 patients in whom acute internal watershed infarction had occurred, and correlate the clinical, neuropsychological and 99mTc-HMPAO SPECT (Single Photon Emission Computed Tomography using 99mtechnetium-hexamethylpropylene amine oxime) cerebral perfusion findings. Four patients had distal middle cerebral artery occlusion demonstra..