Clinical and radiologic correlations of small and large centrum ovale infarcts

Area of Science:

• Neurology
• Vascular Neurology
• Neuroimaging

Background:

• Acute centrum ovale (CO) infarction, especially when confined to perforating long medullary arteries, is infrequently documented.
• This research aims to comprehensively explore the clinical presentations, topographical distribution, and underlying causes of acute CO infarcts.

Purpose of the Study:

• To investigate the full spectrum of clinical findings in patients with acute CO infarct.
• To determine the topography and pathogenesis of acute CO infarcts.
• To correlate risk factors, clinical presentation, and outcomes in a large cohort of CO infarct patients.

Main Methods:

• Retrospective analysis of 64 patients diagnosed with CO infarct.
• Collection of data on patient demographics and vascular risk factors including hypertension, diabetes mellitus, hypercholesterolemia, and smoking.
• Assessment of clinical features, neurological deficits, and functional outcomes using the Barthel index.

Main Results:

• The average patient age was 64.2 years, with 71.8% experiencing large infarcts.
• Hypertension was the predominant risk factor (89.1%), followed by smoking (39%) and cardiac sources of embolism (39%).
• The most common clinical presentation was faciobrachiocrural paralysis with dysarthria (51.6%); 72% of patients achieved independence at discharge.

Conclusions:

• Acute centrum ovale infarcts, particularly large ones, are associated with significant risk factors like hypertension.
• The clinical presentation is diverse, often involving motor deficits and dysarthria.
• While a majority of patients achieved independence, the study highlights a trend towards poorer outcomes in larger CO infarcts compared to prior literature.