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Bilateral Cortical Border-zone Infarction: Title and subTitle BreakA Pseudobrainstem Stroke

Marc Fisher, MD; James B. McQuillen, MD
[+] Author Affiliations

Accepted for publication May 25, 1980.

Reprint requests to Department of Neurology, University of Massachusetts Medical Center, 55 Lake Ave N, Worcester, MA 01605 (Dr Fisher).


Arch Neurol. 1981;38(1):62-63. doi:10.1001/archneur.1981.00510010088021
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• Acute bilateral weakness of the extremities with weakness of the tongue classically signals a medullary lesion. A patient had these signs, but at autopsy, bilateral cortical border-zone infarcts and an entirely normal brainstem were found. This case points out the importance of considering bilateral cortical border-zone infarction in the presence of bilateral motor or sensory signs, especially when there is sparing of facial motor function.

REFERENCES

Barr MD: The Human Nervous System . Hagerstown, Md, Harper & Row Publishers, 1974;, p 324.
Crosby EC, Humphrey T, Lauer EW: Correlative Anatomy of the Nervous System . New York, Macmillan Publishing Co, 1962;, p 118.
Adams JM, Brierly JB, Connor RCR:  The effects of systemic hypotension upon the brain: Clinical and neuropathological observations in 11 cases . Brain 1966;;89:238-268.
Romanul FCA, Abramowicz A:  Changes in brain and pial vessels in arterial border zones . Arch Neurol 1966;;11:40-64.
Romanul FCA:  Some anatomical and pathophysiological aspects of clinical importance in stroke , in Gillingham FJ, Maydsley C, William SAE (eds): Proceedings of Ninth Pfizer International Symposium . New York, Churchill Livingston, 1977;, pp 167-177.
Currier RD:  Syndromes of the medulla oblongata , in Vinken J, Bruyn GW (eds): Handbook of Clinical Neurology . New York, American Elsevier Publishing Co, 1972;, vol 2, pp 217-238.
Davison C:  Syndrome of the anterior spinal artery of the medulla . Arch Neurol Psychiatry 1937;;37:91-107.
Meyer JS, Herndon RM:  Bilateral infarction of the pyramidal tracts in man . Neurology 1962;; 12:637-642.
Currier RD:  The medial medullary syndrome . Univ Mich Med Center 1976;;42:96-104.
Kinkel WR, Jacobs L:  Computerized axial transverse tomography in cerebrovascular disease . Neurology 1976;;26:929-930.
Antunes JL, Schlesinger EB, Michelson WJ, et al:  The value of brain scanning in the management of strokes . Stroke 1975;;6:659-663.

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Barr MD: The Human Nervous System . Hagerstown, Md, Harper & Row Publishers, 1974;, p 324.
Crosby EC, Humphrey T, Lauer EW: Correlative Anatomy of the Nervous System . New York, Macmillan Publishing Co, 1962;, p 118.
Adams JM, Brierly JB, Connor RCR:  The effects of systemic hypotension upon the brain: Clinical and neuropathological observations in 11 cases . Brain 1966;;89:238-268.
Romanul FCA, Abramowicz A:  Changes in brain and pial vessels in arterial border zones . Arch Neurol 1966;;11:40-64.
Romanul FCA:  Some anatomical and pathophysiological aspects of clinical importance in stroke , in Gillingham FJ, Maydsley C, William SAE (eds): Proceedings of Ninth Pfizer International Symposium . New York, Churchill Livingston, 1977;, pp 167-177.
Currier RD:  Syndromes of the medulla oblongata , in Vinken J, Bruyn GW (eds): Handbook of Clinical Neurology . New York, American Elsevier Publishing Co, 1972;, vol 2, pp 217-238.
Davison C:  Syndrome of the anterior spinal artery of the medulla . Arch Neurol Psychiatry 1937;;37:91-107.
Meyer JS, Herndon RM:  Bilateral infarction of the pyramidal tracts in man . Neurology 1962;; 12:637-642.
Currier RD:  The medial medullary syndrome . Univ Mich Med Center 1976;;42:96-104.
Kinkel WR, Jacobs L:  Computerized axial transverse tomography in cerebrovascular disease . Neurology 1976;;26:929-930.
Antunes JL, Schlesinger EB, Michelson WJ, et al:  The value of brain scanning in the management of strokes . Stroke 1975;;6:659-663.

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