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Middle cerebral artery stenosis is a major clinical determinant in striatocapsular small, deep infarction
Oh Young Bang1, Ji Hoe Heo, Jung Yeon Kim
1Department of Neurology, College of Medicine, Ajou University, Woncheon-dong San 5, Paldal-ku, Suwon, Kyungki-do 442-749, South Korea.
Background:
The significance of the stenotic lesions of the middle cerebral artery (MCA) in Asian patients with striatocapsular small, deep infarctions (SSDIs) remains undetermined.
Objectives:
To investigate the frequency of stenotic lesions of the MCA in patients with SSDIs and to evaluate clinical and radiological features in those same patients.
Setting:
Acute stroke registry of a university hospital.
Patients And Methods:
One hundred two Korean patients with acute symptomatic SSDIs underwent cerebral angiography or magnetic resonance angiography and echocardiography. We divided these patients into 2 groups-patients with and without MCA occlusive lesions. The clinical and magnetic resonance image features were compared between these 2 groups.
Results:
Thirty-seven patients (36%) had an ipsilateral proximal MCA lesion, whereas 65 patients (64%) showed no MCA abnormality on cerebral angiography or magnetic resonance angiography. Among 65 patients without an MCA lesion, 18 had an embolic source; the remaining 37 patients had no demonstrable embolic source. There were significant differences in the temporal profile and magnetic resonance imaging findings between the groups. Although the type of lacunar syndrome and the volume of infarcts did not differ between the groups, the unstable temporal profile and magnetic resonance imaging findings of multiple small infarcts in the symptomatic hemisphere were frequently observed in patients with MCA lesions.
Conclusions:
The proximal MCA lesion was a common cause of SSDIs in Korean patients. Depending on the existence of an MCA lesion, the clinical course and magnetic resonance imaging feature of the patients with SSDIs were different.
Insights
Middle cerebral artery (MCA) lesions are a common cause of striatocapsular small, deep infarctions (SSDIs) in Korean patients. Clinical presentation and MRI findings differ based on the presence of MCA lesions.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- The role of middle cerebral artery (MCA) stenosis in striatocapsular small, deep infarctions (SSDIs) among Asian populations is not well-defined.
- Investigating MCA lesions is crucial for understanding the etiology of specific stroke types.
Purpose of the Study:
- To determine the frequency of MCA stenotic lesions in patients diagnosed with SSDIs.
- To analyze the clinical and radiological characteristics associated with MCA lesions in these patients.
Main Methods:
- A cohort of 102 Korean patients with acute symptomatic SSDIs was analyzed.
- Patients underwent cerebral angiography or magnetic resonance angiography and echocardiography.
- Comparison of clinical and MRI features between patients with and without MCA occlusive lesions.
Main Results:
- 36% of patients presented with ipsilateral proximal MCA lesions.
- Patients with MCA lesions showed distinct temporal profiles and MRI findings, including multiple small infarcts.
- No significant differences were observed in lacunar syndrome type or infarct volume.
Conclusions:
- Proximal MCA lesions are a frequent cause of SSDIs in the Korean population.
- The presence of an MCA lesion influences the clinical course and neuroimaging features of patients with SSDIs.