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Hypotensive Cerebral Infarction
Anne G. Osborn, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Abbreviations

          • Hypotensive cerebral infarction (HCI)
        • Synonyms

          • Border zone or watershed infarction
          • Postanoxic encephalopathy
        • Definitions

          • Infarction resulting from insufficient cerebral blood flow (CBF) to meet metabolic demands (low-flow state)

        IMAGING

        • General Features

          • CT Findings

            • MR Findings

              • Angiographic Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Hosseini M et al: Resuscitating the globally ischemic brain: TTM and beyond. Neurotherapeutics. 17(2):539-62, 2020
                                        2. La Rocca G et al: Cortical laminar necrosis as a result of status epilepticus after resection of parafalcal meningioma. Surg Technol Int. 36:159-77, 2020
                                        3. Wang Z et al: Positron emission tomography after ischemic brain injury: current challenges and future developments. Transl Stroke Res. 11(4):628-42, 2020
                                        4. Cannella R et al: Advanced magnetic resonance imaging of cortical laminar necrosis in patients with stroke. Neuroradiol J. 32(6):431-7, 2019
                                        5. Cronberg T: Assessing brain injury after cardiac arrest, towards a quantitative approach. Curr Opin Crit Care. 25(3):211-7, 2019
                                        6. Mai N et al: The post-cardiac arrest syndrome: a case for lung-brain coupling and opportunities for neuroprotection. J Cereb Blood Flow Metab. 39(6):939-58, 2019
                                        7. Vamadevan T et al: Imaging appearances of toxic and acquired metabolic encephalopathic disorders. Br J Hosp Med (Lond). 80(7):372-6, 2019
                                        8. Bhatt AA et al: Beyond stroke-uncommon causes of diffusion restriction in the basal ganglia. Emerg Radiol. 25(1):87-92, 2018
                                        9. Godinho MV et al: Hypoxic, toxic, and acquired metabolic encephalopathies at the emergency room: the role of magnetic resonance imaging. Semin Ultrasound CT MR. 39(5):481-94, 2018
                                        10. Keijzer HM et al: Brain imaging in comatose survivors of cardiac arrest: pathophysiological correlates and prognostic properties. Resuscitation. 133:124-36, 2018
                                        11. Sekhon MS et al: Clinical pathophysiology of hypoxic ischemic brain injury after cardiac arrest: a "two-hit" model. Crit Care. 21(1):90, 2017
                                        12. Derdeyn CP et al: Severe hemodynamic impairment and border zone--region infarction. Radiology. 220(1):195-201, 2001
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Hypotensive cerebral infarction (HCI)
                                              • Synonyms

                                                • Border zone or watershed infarction
                                                • Postanoxic encephalopathy
                                              • Definitions

                                                • Infarction resulting from insufficient cerebral blood flow (CBF) to meet metabolic demands (low-flow state)

                                              IMAGING

                                              • General Features

                                                • CT Findings

                                                  • MR Findings

                                                    • Angiographic Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Staging, Grading, & Classification

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Hosseini M et al: Resuscitating the globally ischemic brain: TTM and beyond. Neurotherapeutics. 17(2):539-62, 2020
                                                                              2. La Rocca G et al: Cortical laminar necrosis as a result of status epilepticus after resection of parafalcal meningioma. Surg Technol Int. 36:159-77, 2020
                                                                              3. Wang Z et al: Positron emission tomography after ischemic brain injury: current challenges and future developments. Transl Stroke Res. 11(4):628-42, 2020
                                                                              4. Cannella R et al: Advanced magnetic resonance imaging of cortical laminar necrosis in patients with stroke. Neuroradiol J. 32(6):431-7, 2019
                                                                              5. Cronberg T: Assessing brain injury after cardiac arrest, towards a quantitative approach. Curr Opin Crit Care. 25(3):211-7, 2019
                                                                              6. Mai N et al: The post-cardiac arrest syndrome: a case for lung-brain coupling and opportunities for neuroprotection. J Cereb Blood Flow Metab. 39(6):939-58, 2019
                                                                              7. Vamadevan T et al: Imaging appearances of toxic and acquired metabolic encephalopathic disorders. Br J Hosp Med (Lond). 80(7):372-6, 2019
                                                                              8. Bhatt AA et al: Beyond stroke-uncommon causes of diffusion restriction in the basal ganglia. Emerg Radiol. 25(1):87-92, 2018
                                                                              9. Godinho MV et al: Hypoxic, toxic, and acquired metabolic encephalopathies at the emergency room: the role of magnetic resonance imaging. Semin Ultrasound CT MR. 39(5):481-94, 2018
                                                                              10. Keijzer HM et al: Brain imaging in comatose survivors of cardiac arrest: pathophysiological correlates and prognostic properties. Resuscitation. 133:124-36, 2018
                                                                              11. Sekhon MS et al: Clinical pathophysiology of hypoxic ischemic brain injury after cardiac arrest: a "two-hit" model. Crit Care. 21(1):90, 2017
                                                                              12. Derdeyn CP et al: Severe hemodynamic impairment and border zone--region infarction. Radiology. 220(1):195-201, 2001