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September 1987

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

Author Affiliations

From the Department of Neurology, St Thomas' Hospital, London.

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.