SCINTIGRAPHIC DEMONSTRATION OF CEREBRALINFARCTON IN A “WATERSHED―ISTRIBUTION

A 24-year-old woman who had a history of inter mittent leg vein thrombophiebitis suffered sudden onset of chest pain and shortness of breath shortly after arising from a nap in the evening of Nov. 10, 1970. She collapsed and was taken to Parkland Memorial Hospital by ambulance. On arrival her blood pressure was 104/70 and her pulse was 140/ mm and regular. She exhibited pallor and tachypnea, as well as cyanosis of the nail beds. Massive pul monary embolism was suspected, and a pulmonary arteriogram was performed at once. A large central saddle clot was found to have obstructed the entire right pulmonary circulation as well as the vessels of the lingula and left lower lobe. Only upper segments of the left upper lobe circulation were preserved. A pulmonary embolectomy was performed, followed by ligation of the inferior vena cava. As the patient recovered from anesthesia early on Nov. 11, 1970, left extremity weakness was noted which progressed rapidly to left hemiplegia. Although only a residual effect of anesthesia was at first suspected, she made