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September 1987

Clinical Features of Ischemia in Cerebral Arterial Border Zones After Periods of Reduced Cerebral Blood Flow

Arch Neurol. 1987;44(9):934-940. doi:10.1001/archneur.1987.00520210036016

• The clinical syndrome of borderzone ischemia is described in eight patients. Cerebral damage in four occurred during or after cardiac surgery and the other four patients had each experienced a period of severe hypotension. Cerebral blindness and visual disorientation are the most regular features and are produced by ischemic lesions in the parieto-occipital region, the common border-zone territory between all three arterial territories. Some patients show bibrachial sensorimotor impairment and a disturbance of volitional saccadic eye movement caused by more anteriorly placed ischemia in the anterior-middle artery border zone. Some show a temporary dyslexia dysgraphia and memory defect related to bilateral parietotemporal lesions in the middle-posterior border zone.