Which MRI findings are characteristic of thromboembolic infarction in the workup of acute stroke?

Updated: Dec 19, 2018
  • Author: Souvik Sen, MD, MPH, MS, FAHA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Answer

Thromboembolic infarction is the most common form of infarction. Typically, it is observed on MRI as a wedge-shaped infarct in the particular vascular distribution. Data support the hypothesis that a single infarct in a vascular territory is more likely to be thrombotic than are multiple infarcts, which are more likely to be embolic.

Watershed infarction occurs at the distal margins of specific arterial territories. It can occur superficially and can occur deep in the brain parenchyma. Common etiologies for this lesion include hypotension, cardiac and respiratory arrest, and proximal arterial stenosis or occlusion. MRI findings follow the pattern of incomplete thromboembolic ischemic infarction in T1 and T2 morphologic and signal changes, with early parenchymal enhancement suggesting early reperfusion. Studies show that this type of infarction could be more readily detected by using DWI.


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