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Distribution of cerebral microembolism in the anterior and middle cerebral arteries

C A Wijman1, V L Babikian, M R Winter

  • 1Department of Neurology, Boston University School of Medicine and Boston Veterans Administration Medical Center, MA 02130, USA.

Acta Neurologica Scandinavica
|February 24, 2000
PubMed
Abstract

Insights

Cerebral microemboli are more common in the middle cerebral artery (MCA) territory than the anterior cerebral artery (ACA). This finding helps explain why strokes are more frequent in the MCA territory.

Area of Science:

  • Neuroscience
  • Vascular Neurology
  • Medical Imaging

Background:

  • Cerebral infarcts disproportionately affect the middle cerebral artery (MCA) over the anterior cerebral artery (ACA) territory.
  • The underlying reasons for this uneven distribution of cerebrovascular events remain unclear.

Purpose of the Study:

  • To investigate the distribution patterns of cerebral microemboli.
  • To determine if microemboli detection via transcranial Doppler (TCD) ultrasound correlates with stroke incidence in MCA and ACA territories.

Main Methods:

  • Reviewed 375 transcranial Doppler (TCD) studies for microembolic signals (MES) over 32 months.
  • Analyzed 28 studies with MES in both MCA and ACA territories on the same side.
  • Applied established criteria for MES identification and off-line review.

Main Results:

  • Microembolic signals (MES) were significantly more frequent in the MCA than the ACA (85.7% of studies, P < 0.01).
  • Of 979 total MES, 70.4% were in the MCA and 29.6% in the ACA (P < 0.01).
  • MCA MES had lower intensity (12.2 dB vs 14.8 dB, P=0.05) and longer duration (38.1 ms vs 30.7 ms, P=0.05) compared to ACA MES.

Conclusions:

  • Cerebral microembolism occurs more frequently in the MCA territory compared to the ACA territory.
  • This higher prevalence of microemboli in the MCA may explain the greater incidence of cerebral infarcts in this region.
  • Distinct characteristics exist between microembolic signals in the MCA and ACA territories.

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