Table of ContentsView AllTable of ContentsSymptoms and Warning SignsCauses and Risk FactorsDiagnosisTreatment and Prognosis
Table of ContentsView All
View All
Table of Contents
Symptoms and Warning Signs
Causes and Risk Factors
Diagnosis
Treatment and Prognosis
A watershed stroke occurs when the blood flow to parts of the brain, known as border zones, is severely reduced, leading to brain tissue death. The border zones are vulnerable because they are situated furthest away from the three major arteries that service the brain.
This article discusses the symptoms, causes, and diagnosis of watershed strokes and how they are treated based on the underlying cause.
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Symptoms and Warning Signs of a Watershed Stroke
Watershed strokes are one type ofischemic stroke. Ischemic strokes are those in which the blood flow to the brain is restricted or reduced. They differ fromhemorrhagic strokesin which blood vessels servicing the brain burst.
Symptoms of a watershed stroke might include:
Causes
The three most common causes of a watershed include:
Risk Factors
The risk factors for a watershed stroke are the same as for any other form of ischemic stroke. They typically involve a combination of lifestyle and medical factors, such as:
A watershed stroke is diagnosed in the same way as any other stroke. It starts with a review of your medical history and a physical exam along with one or moreimaging teststo determine the cause of your stroke.
Imaging studies used to diagnose a stroke include:
Blood tests also may be ordered to check for risk factors associated with ischemic stroke, including cholesterol levels, triglyceride levels, and blood coagulation tests.
Treatment
If the obstruction is due to carotid stenosis, a surgical procedure known ascarotid endarterectomymay be used to widen the carotid artery and increase blood flow.
Alternatively, the carotid artery can be accessed throughpercutaneous angioplasty. This involves the insertion of a tube (called a balloon catheter) that is fed to the site of obstruction and inflated to widen the vessel. A tiny mesh tube, called astent, can then be placed in the vessel to keep it open.
If a watershed stroke was the result of severe blood loss or low blood pressure, your treatment is more likely to be focused on maintaining adequate fluid and blood pressure with intravenous (IV) fluids and/or a blood transfusion.
Prognosis
A watershed stroke is rarely fatal but can cause severe disability, particularly if it is not treated appropriately. Damage to the border zones of the brain can lead to difficulties with movement as well as speech and muscle coordination.Dementia(involving problems with thinking, remembering, learning, reasoning, or language) is also common.
With the appropriate rehabilitation (which may involve physical, occupational, speech, or language therapies), many of the abilities can be improved upon or restored. Even so, rehabilitation efforts can take time.
Summary
A watershed stroke is a type of stroke that involves tissues situated furthest away from the main arteries of the brain. Symptoms are similar to other types of stroke, although they are often milder and easily missed at first. Even so, a watershed stroke can lead to severe disability, including dementia and the loss of motor function, if not diagnosed and treated promptly.
A Word From Verywell
A stroke is a major event that can change your life. As you recover, you will most likely get a medical workup to identify whether you have ongoingrisk factorsfor stroke. This is important because having a stroke places you at risk of having another one.
By taking preventive steps, such as quitting cigarettes, taking blood thinners, and exercising regularly, you can better ensure that your first stroke is your last.
2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Juergenson I, Mazzucco S, Tinazzi M.A typical example of cerebral watershed infarct.Clin Pract. 2011;1(4):e114.doi:10.4081/cp.2011.e114American Stroke Association.Ischemic stroke treatment. Reviewed December 5, 2018.Additional ReadingWeill C, Suissa L, Darcourt J, Mahagne MH,The Pathophysiology of watershed infarction: A three-dimensional time-of-flight magnetic resonance angiography study,J Stroke Cerebrovasc Dis. 2017 Sep;26(9):1966-1973. doi:10.1016/j.jstrokecerebrovasdis.2017.06.016
2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Juergenson I, Mazzucco S, Tinazzi M.A typical example of cerebral watershed infarct.Clin Pract. 2011;1(4):e114.doi:10.4081/cp.2011.e114American Stroke Association.Ischemic stroke treatment. Reviewed December 5, 2018.Additional ReadingWeill C, Suissa L, Darcourt J, Mahagne MH,The Pathophysiology of watershed infarction: A three-dimensional time-of-flight magnetic resonance angiography study,J Stroke Cerebrovasc Dis. 2017 Sep;26(9):1966-1973. doi:10.1016/j.jstrokecerebrovasdis.2017.06.016
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Juergenson I, Mazzucco S, Tinazzi M.A typical example of cerebral watershed infarct.Clin Pract. 2011;1(4):e114.doi:10.4081/cp.2011.e114American Stroke Association.Ischemic stroke treatment. Reviewed December 5, 2018.
Juergenson I, Mazzucco S, Tinazzi M.A typical example of cerebral watershed infarct.Clin Pract. 2011;1(4):e114.doi:10.4081/cp.2011.e114
American Stroke Association.Ischemic stroke treatment. Reviewed December 5, 2018.
Weill C, Suissa L, Darcourt J, Mahagne MH,The Pathophysiology of watershed infarction: A three-dimensional time-of-flight magnetic resonance angiography study,J Stroke Cerebrovasc Dis. 2017 Sep;26(9):1966-1973. doi:10.1016/j.jstrokecerebrovasdis.2017.06.016
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