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In November 2021, Andrea Zini from Italy and others reported in Neuroradiology 5 patients with bulbar watershed infarction.
The characteristics of these patients are as follows:
The characteristics of these patients are as follows:
Figure.
A schematic diagram of brain magnetic resonance imaging and medullary supply arteries (F) of five patients with medullary watershed infarction (AE)
.
Note that all five cases were comma-shaped lesions, corresponding to the marginal zone between the vertebral artery and the posterior inferior cerebellar artery
Figure.
The authors believe that atherosclerosis and arterial dissection rarely involve only the medulla oblongata.
These five patients suggest that vertebral artery occlusion or hemodynamic damage caused by hypotension can lead to watershed infarction between the vertebral artery and the posterior inferior cerebellar artery branch
.
Although the size of the lesion is consistent with the lacunar stroke, the shape of the lesion is not wedge-shaped, lesion distribution, thin comma shape, and low perfusion (due to vertebral artery occlusion or hypotension) may indicate marginal zone infarction, rather than the cause of microthromboembolism
The authors believe that atherosclerosis and arterial dissection rarely involve only the medulla oblongata.
Literature source:
Neuroradiology.
2021 Nov;63(11):1947-1950.
2021 Nov;63(11):1947-1950.
doi: 10.
Bulbar watershed ischemic stroke: the comma-shaped sign-a case series
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