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Acute caudate vascular lesions

E Kumral1, D Evyapan, K Balkir

  • 1Division of Cerebrovascular and Neuropsychology Unit, Department of Neurology, Faculty of Medicine, Ege University, Izmir, Turkey. ekumral@med.ege.edu.tr

Stroke
|January 8, 1999
PubMed
Summary

This study analyzed caudate nucleus strokes, finding small-artery disease and cardiac embolism as common causes. Behavioral and neurological deficits often resulted from damage to specific caudate subnuclei and nearby structures.

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Area of Science:

  • Neurology
  • Neuroscience
  • Vascular Neurology

Background:

  • Caudate nucleus lesions, including infarcts and hemorrhages, present unique clinical challenges.
  • Understanding the demographic, risk factor, and clinical profiles of caudate stroke is crucial for diagnosis and management.

Purpose of the Study:

  • To evaluate demographic features, risk factors, clinical profiles, and behavioral abnormalities in patients with caudate nucleus lesions.
  • To differentiate between caudate infarct and hemorrhage presentations and outcomes.

Main Methods:

  • Retrospective analysis of patients with acute caudate stroke confirmed by CT or MRI over a 5-year period.
  • Database review including risk factors, clinical features, stroke type, mechanism, and vascular territories.

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Main Results:

  • Thirty-one patients (mean age 62.3 years) experienced acute caudate stroke (25 infarcts, 6 hemorrhages).
  • Key risk factors for infarct included hypertension, hypercholesterolemia, and diabetes mellitus. Small-artery disease (59%) and cardiac embolism (20%) were primary causes.
  • Common neurological deficits included abulia, psychic akinesia, frontal system abnormalities, speech deficits, and neglect syndromes.

Conclusions:

  • Caudate nucleus vascular lesions, particularly with neighboring structure involvement, constitute a distinct stroke syndrome.
  • Small-artery disease and cardiac embolism are significant etiologies. Clinical presentation of caudate hemorrhage can mimic subarachnoid hemorrhage.
  • Behavioral abnormalities are linked to specific caudate subnuclei damage and anterior limb of internal capsule lesions.