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Abstract Watershed infarctions (WSI) are ischemic lesions that occur in characteristic locations at the junction between two(or three)main arterial territories. It is classified neuroradiologically into: Cortical watershed and internal watershed(Mangla et al., 2011; D’Amore and Paciaroni et al., 2012).Pathogenesis of watershed infarction still remains debated.Zulch and Behrend, 1961 reported the typical topographical areas of WSI and hypothesized their hemodynamic mechanism but nowadays some studies have implicated two mechanisms in the pathogenesis of WSI; a reduced cerebral perfusion and micro-emboli(Wong et al., 2002 Mimojian- Mayor and Baron,2005).The aim of this work was studying the risk factors, clinical presentation and neuroradiological features of watershed infarction to determine its possible etiology. This study was carried out in Neuropsychiatry Department -Tanta University Hospitals on sixty Patients had been recruited from stroke unit during the period from Mach 2014 to March 2015 and diagnosed radiologically to have acute cerebral watershed infarction. Patients below the age of 18 and patients with associated cerebral hemorrhage, subarachnoid hemorrhage, brain tumors or leukoariosis were excluded from the study. This study was included 60 Patient with watershed infarction; 36 patients diagnosed as CWS, 23 patients IWS and one patient had both |