Clinical Characteristics of Middle Cerebral Artery Pial Territory Infarcts.
- Author:
Yong Seok LEE
1
;
Jae Kyu ROH
Author Information
1. Department of Neurology, College of Medicine, Seoul National University, Korea.
- Publication Type:Original Article
- MeSH:
Angiography;
Aphasia;
Arm;
Brain;
Carotid Artery, Internal;
Constriction, Pathologic;
Echocardiography;
Electrocardiography;
Embolism;
Heart;
Hematologic Tests;
Humans;
Hypesthesia;
Korea;
Leg;
Magnetic Resonance Imaging;
Middle Cerebral Artery*;
Risk Factors;
Visual Fields
- From:Journal of the Korean Neurological Association
1995;13(4):788-794
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Infarct limited to the pial branch territory of the middle cerebral artery(IPBMCA) is a common entity of cerebrovascular diseases. Atherothrombosis of middle cerebral (MCA) or internal carotid artery (ICA), and cardiogenic embolism are presumed causes of this type of cerebral infarct. Thirty-three patients with acute IPBMCA were systematically studied with brain CT, MRI, electrocardiography, blood tests, echocardiography, and in selected cases with angiography or MRA. Hypertension(58%) and heart disease(37%) were common risk factors, and previous episodes of TIA were present in 27%. Half of the patients undergoing angiography revealed stenosis or occlusion of MCA, and evidence of carotid disease was found in 39% of patients with large-artery disease(LAD). Presumed causes of infarct were LAD in half and cardioembolism in one-fourth. Multiple combinations of motor weakness, hypesthesia, visual field defect and aphasia or hemineglect were the clinical presentation. Motor weakness was frequent(91%), and involvement of the f ace, arm and leg was the most common pattern. In our study, atherothrombosis of MCA itself is presumed to be the leading cause of IPBMCA in Korea, but cardioembolism, artery-to-artery embolism from proximal ICA, and occlusion of ICA are also supposed to contribute to the pathogenesis of IPBMCA.
