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Caudate infarcts.

L R Caplan1, J D Schmahmann, C S Kase

  • 1New England Medical Center, Boston, Mass.

Archives of Neurology
|February 1, 1990
PubMed
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Caudate nucleus infarcts frequently cause motor and cognitive deficits like abulia and dysarthria. These strokes, often linked to penetrating artery disease, highlight the caudate nucleus

Area of Science:

  • Neurology
  • Neuroimaging
  • Cerebrovascular Disease

Background:

  • The caudate nucleus plays a crucial role in motor control, executive functions, and emotion.
  • Ischemic strokes affecting the caudate nucleus can lead to diverse neurological deficits.
  • Understanding the clinical manifestations and vascular territories involved is essential for diagnosis and management.

Purpose of the Study:

  • To investigate the clinical presentation and neuroanatomical correlates of caudate nucleus infarcts.
  • To identify common motor, cognitive, and behavioral abnormalities associated with these lesions.
  • To explore the potential vascular mechanisms underlying caudate nucleus infarcts.

Main Methods:

  • Retrospective analysis of 18 patients with confirmed caudate nucleus infarcts.

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  • Clinical assessment of motor, cognitive, and behavioral symptoms.
  • Review of neuroimaging findings to determine infarct location and extension.
  • Correlation of clinical deficits with infarct topography and presumed etiology.

    • Main Results:

    • Eighteen patients presented with caudate nucleus infarcts (10 left, 8 right).
    • Infarcts frequently extended into the anterior limb of the internal capsule (9 patients) and anterior putamen (5 patients).
    • Common symptoms included motor signs (hemiparesis), dysarthria (11), abulia (10), agitation (7), contralateral neglect (3, all right-sided), and language deficits (2, all left-sided).
    • Most patients had risk factors for penetrating artery disease.

    Conclusions:

    • Caudate nucleus infarcts are associated with a spectrum of motor, cognitive, and behavioral impairments.
    • The pattern of deficits often correlates with the extent of infarction into adjacent structures like the internal capsule and putamen.
    • Occlusion of penetrating arteries, particularly Heubner's artery or perforators from the anterior/middle cerebral arteries, is the likely cause.