Changes in Brain and Pial Vessels in Arterial Border Zones

Abstract

Introduction Selective infarction of the portions of brain situated in border zones between the territories of supply of the major cerebral arteries has been described in the past on several occasions and has been attributed to a variety of disease processes. Pathological changes in small pial vessels over the areas of infarction were encountered in some of these cases, and these were also interpreted differently by various authors. We wish to present evidence of what we believe to be a common mechanism responsible for the pathological changes in all such cases. In 1934 Pentschew¹ studied nine brains with granular atrophy of the cerebral cortex. The brain damage in these cases had been attributed to several causes including atherosclerosis. In all the brains the granular atrophy affected the same parts of the cerebral cortex: the middle frontal gyri, the upper portions of the pre- and postcentral gyri, the superior parietal