Anterior cerebral artery territory infarctions : a clinico-radiologic study based on CT

Clinical features of acute infarcts in the anterior cerebral artery territory are correlated to the topography of lesions on CT Scan in 15 patients. The most common clinical feature, hemiparesis with crural dominance correlated well with the involvement to the contralateral paracentral lobule in all 12 patients. Patients who had facio-brachial weakness and hemiparesis showed infarcts limited to the periventricular white matter around anterior horn of lateral ventricle. Large medial-basal frontal lesions were associated with behavioural disturbances in 5 patients. In 3 patients who had patchy lesions involving the paracentral lobule, supplementary motor area and medial frontal areas with sparing of the fronto-polar areas had bladder disturbances in3 patients, while 3 other patients who had involvement of the same areas did not show bladder disturbances. The size of the infarct seems to have not much correlation as compared to the site and structures involved. Supplementary motor area lesions had associated speech disturbances like mutism, transcortical motor aphasia and decreased nonfluent verbal output, in one case each. Clinical features in anterior cerebral artery territory have more often fair correlation with topographic lesions on CT.