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Advanced Technical IVT

watershed infarct

Brain infarction occurring in border zones between major arterial territories due to hypoperfusion.

Full Definition

A watershed infarct, also known as a border zone infarct, occurs in the regions between major cerebral arterial territories where blood supply is most tenuous. These areas are particularly vulnerable during episodes of global cerebral hypoperfusion, such as cardiac arrest, severe hypotension, or carotid occlusion. Watershed infarcts typically occur between the anterior cerebral artery and middle cerebral artery territories, or between the middle cerebral artery and posterior cerebral artery territories. They often present as linear or crescentic areas of infarction parallel to the brain surface and may be bilateral in cases of global hypoperfusion.

Usage

Usage note: Distinguish from other stroke patterns and specify bilateral vs unilateral distribution.

In Context

  • "Bilateral watershed infarcts are present in the frontoparietal regions, suggesting recent hypotensive episode." — Stroke imaging report
  • "The pattern of injury is consistent with watershed infarction rather than embolic stroke." — Stroke mechanism assessment

Also known as

border zone infarct hemodynamic infarct

Contrasted with

territorial infarct embolic infarct

Don't confuse with

lacunar infarct territorial infarct

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