Bilirubin labeling of borderzone and anterior cerebral artery territory infarction.

نویسندگان

  • Aaron L Berkowitz
  • Shu-Hsien Sheu
  • Matthew F Rose
  • Ivana Delalle
  • Rebecca D Folkerth
چکیده

A 50-year-old woman developed multiorgan system failure secondary to sepsis. She became obtunded during a period of hypotension, and cranial CT demonstrated diffuse borderzone infarction. Brain autopsy revealed green pigmentation in areas of infarction due to vascular leakage of bilirubin at sites of blood–brain barrier disruption, mapping the borderzone regions and bilateral posterior anterior cerebral artery (ACA) territories with this endogenous label (total bilirubin at time of death was 24 mg/dL; direct bilirubin was 19 mg/dL; ACA infarction was not present on the initial CT, and was thought to be secondary to herniation) (figure). This brain–liver association evokes the first description of pathology in the borderzone regions in 1883 by SamuelJean Pozzi, who attributed the lesions to cortical “cirrhosis.”

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عنوان ژورنال:
  • Neurology

دوره 81 14  شماره 

صفحات  -

تاریخ انتشار 2013