CT-defined large subcortical infarcts: correlation of location with site of cerebrovascular occlusive disease
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Published on: July 21, 2013
1Department of Neurosurgery, Junwakai Memorial Hospital, Komatsu, Japan.
Insights
Large subcortical infarcts were correlated with specific cerebrovascular occlusive diseases. Middle cerebral artery disease often caused striatocapsular and corona radiata infarcts, while internal carotid artery disease affected the centrum semiovale.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Large subcortical infarcts are a significant cause of neurological deficits.
- Understanding the relationship between infarct location and underlying cerebrovascular disease is crucial for effective treatment and prevention.
Purpose of the Study:
- To establish a correlation between the anatomical location of large subcortical infarcts and the specific site of cerebrovascular occlusive disease.
- To differentiate infarct patterns based on the affected cerebral artery.
Main Methods:
- A retrospective analysis of CT and angiographic findings was performed on 38 patients.
- Patients presented with newly developed large subcortical infarcts (≥2.0 cm).
- Infarcts were classified into striatocapsular, corona radiata, and centrum semiovale types.
Main Results:
- The most common infarct combination was striatocapsular and corona radiata (36.8%).
- Atherosclerotic occlusive disease was prevalent (89.5%), with internal carotid artery (57.9%) and middle cerebral artery (31.6%) disease being most frequent.
- Middle cerebral artery occlusive disease predominantly led to striatocapsular and corona radiata infarcts, whereas internal carotid artery occlusive disease more commonly resulted in centrum semiovale infarcts.
Conclusions:
- Middle cerebral artery occlusive disease is strongly associated with striatocapsular and/or corona radiata infarcts.
- Centrum semiovale lesions are typically linked to internal carotid artery occlusive disease.
- These findings highlight the distinct patterns of subcortical infarcts based on the affected major cerebral artery, aiding in the diagnosis and management of cerebrovascular disease.
Purpose:
To correlate the location of large subcortical infarcts with the site of cerebrovascular occlusive disease.
Methods:
We examined CT and angiographic findings of 38 patients with major arterial occlusive disease and newly developed large subcortical infarcts of 2.0 cm or more, which were classified into three types: striatocapsular infarcts in the basal ganglia, terminal supply area infarcts in the corona radiata, and terminal supply area infarcts in the centrum semiovale.
Results:
Two or three of the types of infarct were sometimes combined; the combination of the striatocapsular and corona radiata infarcts was the most frequent (14 [36.8%] of 38). Thirty-four (89.5%) had atherosclerotic major arterial occlusive diseases; 22 (57.9%) had occlusive diseases of the internal carotid artery, and 12 (31.6%) had diseases of the middle cerebral artery. The other 4 (10.5%) had embolic transient middle cerebral artery occlusion. Middle cerebral artery occlusive diseases frequently produced striatocapsular (13 [81.3%] of 16) and corona radiata (13 [81.3%] of 16) infarcts but never induced the centrum semiovale lesions. On the other hand, in patients with internal carotid artery occlusive disease, the centrum semiovale (16 [72.7%] of 22) was more susceptible to ischemia than the striatocapsular region (11 [50%] of 22) or the corona radiata (9 [40.9%] of 22).
Conclusions:
Middle cerebral artery occlusive diseases frequently produced striatocapsular and/or corona radiata infarcts but never induced the centrum semiovale lesions, which were usually associated with internal carotid artery occlusive diseases.
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