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Acute multiple infarction involving the anterior circulation

J Bogousslavsky1, A Bernasconi, E Kumral

  • 1Department of Neurology, Centre Hospitalier, Universitaire Vaudois, Lausanne, Switzerland.

Archives of Neurology
|January 1, 1996
PubMed
Summary

Acute multiple infarcts in the anterior circulation occur in 5% of first ischemic strokes and can affect both hemispheres. These strokes, often caused by cardioembolism or large artery disease, can present with specific neurological patterns.

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Area of Science:

  • Neurology
  • Neuroimaging
  • Stroke Medicine

Background:

  • Acute multiple infarcts in the anterior circulation are a significant cause of stroke.
  • Understanding their patterns is crucial for diagnosis and management.

Purpose of the Study:

  • To determine the frequency of acute multiple infarcts in the anterior circulation.
  • To characterize their clinical, topographic, and etiologic patterns.

Main Methods:

  • Analysis of a prospective acute stroke registry.
  • Utilized computed tomography and magnetic resonance imaging with gadolinium enhancement.

Main Results:

  • 5% of patients (40/751) experienced acute multiple anterior circulation infarcts.

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  • Infarct patterns included superficial, deep, superficial/deep, and anterior/posterior circulation involvement.
  • Large-artery disease (33%) and cardioembolism (28%) were common etiologies; bilateral infarcts linked to cardioembolism or bilateral large-artery disease.
  • One-month outcomes showed 25% independence, 33% disability, and 40% mortality or complete dependence.

    • Conclusions:

    • Acute multiple anterior circulation infarcts are often bilateral and can involve the posterior circulation.
    • Cardioembolism and bilateral carotid atheroma are primary causes.
    • Specific neurological patterns may aid in pre-imaging diagnosis.