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Deep cerebral infarcts extending to the subinsular region
E H Wong1, P M Pullicino, R Benedict
1Department of Neurology, State University of New York at Buffalo, Buffalo, NY 14203, USA.
Stroke
|October 6, 2001
Summary
Deep cerebral infarcts (DCIs) share clinical features with paraventricular infarcts. Hypoperfusion, often due to large artery occlusion, is a key factor in DCI development, suggesting poorer collateral supply in these larger strokes.
Area of Science:
- Neurology
- Neuroradiology
- Stroke Medicine
Background:
- Deep cerebral infarcts (DCIs) extending to the subinsular region represent a specific stroke subtype.
- Understanding their characteristics is crucial for diagnosis and management.
Purpose of the Study:
- To delineate the clinical and radiological features of DCIs.
- To investigate the underlying pathogenetic mechanisms of DCIs.
Main Methods:
- Defined DCIs based on specific imaging criteria (subcortical infarcts with paraventricular >1.5 cm and subinsular extent).
- Reviewed patient imaging, clinical data, and risk factors.
- Compared DCIs with internal border zone infarcts.
Main Results:
- Eight patients with DCIs were studied.
- Typical symptoms included hemiparesis, aphasia, dysarthria, and dysphagia.
- Hypoperfusion (e.g., carotid occlusion) was identified in 75% of cases, and cardioembolism in 38%.
Conclusions:
- DCIs share clinical and pathogenetic features with internal border zone infarcts.
- Hypoperfusion, particularly large-artery occlusion, is a primary risk factor for DCIs.
- Larger DCI size may correlate with compromised collateral blood flow.