[Infarct of the territory of the left anterior cerebral artery. I. Clinico-computerized tomographic correlations]

Clinico-topographic correlations were made in 10 consecutive patients with an isolated infarct in the territory of the left anterior cerebral artery, with sagittal reconstruction of the lesions. Our results suggest that the classical syndromes reported in autopsied patients with large lesions often associated with other infarcts are uncommon. The classical crural hemiparesis was often replaced by a facio-brachio-crural or brachio-facial hemiparesis, when the lesion was anterior to the pre-central region and extended deeply toward the anterior part of the internal capsule. Hemisensory disturbances were related to involvement of the post-central region, were always associated with a hemiparesis and involved mainly the elementary modes of sensation. A grasp reflex occurred only when the contralateral lesion was limited to the orbito-frontal region, in the absence of a severe hemiparesis. Prolonged urinary incontinence, generalized hypokinesia and opposition hypertonia (Gegenhalten) were rare and were related to the size of the lesion. These findings suggest that partial infarcts in the territory of the anterior cerebral artery may be difficult to differentiate clinically from middle cerebral artery territory infarcts.