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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping

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Clinical manifestation of acute cerebral infarcts in multiple arterial territories

Vojtech Novotny1,2, Sander Johan Aarli1,2, Andrej Netland Khanevski1

  • 1Department of Neurology, Haukeland University Hospital, Bergen, Norway.

Brain and Behavior
|August 1, 2021
PubMed
Abstract

Insights

Most acute cerebral infarcts in multiple arterial territories (MACI) show single-territory symptoms. Diffusion-weighted MRI is crucial for diagnosing MACI, revealing lesion distribution and number for accurate classification.

Area of Science:

  • Neurology
  • Radiology
  • Stroke Medicine

Background:

  • Acute cerebral infarcts in multiple arterial territories (MACI) present diagnostic challenges.
  • Understanding the clinical and radiological characteristics of MACI is essential for effective patient management.

Purpose of the Study:

  • To assess the frequencies and radiological features of single- versus multiterritory clinical manifestations in patients with MACI.
  • To identify factors associated with single-territory versus multiterritory clinical presentation in MACI.

Main Methods:

  • Retrospective review of 311 patients with MACI admitted between 2006 and 2017.
  • Analysis of diffusion-weighted magnetic resonance imaging (DW-MRI) and clinical data.
  • Comparison of topographical lesion distribution, lesion count, and Oxfordshire Community Stroke Project (OCSP) classification between single- and multiterritory presentations.

Main Results:

  • 71.4% of MACI patients presented with single-territory clinical manifestation.
  • Single-territory manifestation was associated with left hemisphere involvement, fewer than five lesions, and partial anterior circulation infarct (PACI) syndrome.
  • Multiterritory manifestation was linked to involvement of all three territories, more than ten lesions, and total anterior circulation infarct (TACI) syndrome.

Conclusions:

  • The majority of MACI patients exhibit single-territory clinical symptoms upon admission.
  • Diffusion-weighted MRI is indispensable for definitive MACI diagnosis, aiding in the characterization of lesion patterns and clinical syndromes.
Keywords:
diffusion-weighted imagingmultiple strokeneurological manifestationsymptoms and signs

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