No abstract available.
Infarction* ; Middle Cerebral Artery*

Objective: To assess fluid-attenuated inversion recovery (FLAIR) vascular hyper-intensity (FVH) and explore its relationship with CT perfusion (CTP) penumbral/infarct core mismatch ratio and diffusion weighted imaging (DWI) final infarct volume in acute ischemic stroke (AIS) patients with middle cerebral artery occlusion (MCAO). Methods: The CTP and MRI images of 38 AIS patients with MCAO were reviewed. The FVH score (longitudinal direction) [FVH score (L)] and FVH score (transverse direction) [FVH score (T)] were quantified on the FLAIR images. The FVH score (L) (range, 0-16) was based on a rostrocaudal extension of FVH and the FVH score (T) (range, 0-3) was based on FVH supply of the occluded MCA territory. The mismatch ratio was calculated from the ratio of the [mean transit time - cerebral blood volume (CBV)] lesion/CBV lesion on the CTP images. The DWI infarct volume was measured on the DWI images. Results: The mismatch ratio was larger for the group of FVH score (L)=7~8 than those of FVH score (L)=5~6 and FVH score (L)=3~4 (p=0.03), whereas the DWI infarct volume was smaller (p=0.04). Similarly, the mismatch ratio of FVH score (T)=2~3 group was larger than FVH score (T)=1 group (p=0.01), whereas the DWI infarct volume was smaller (p=0.02). Both FVH score (L) and FVH score (T) correlated positively with mismatch ratio (P=0.02, P=0.001, respectively), but negatively with DWI infarct volume (P=0.03, P=0.004, respectively). Conclusions: Higher FVH score is associated with larger mismatch ratio and smaller DWI infarct volume in AIS patients with MCAO. FLAIR vascular hyperintensity may represent collateral arterial circulation, and may play a role in protecting the ischemic penumbra.
Infarction, Middle Cerebral Artery

No abstract available.
Atherosclerosis ; Cerebral Angiography ; Infarction, Middle Cerebral Artery

Early spontaneous recanalization of the middle cerebral artery in acute ischemic phase artery is not uncommon, whereas the late spontaneous recanalization of chronic occluded artery is a very rare phenomenon and exact incidence and the timing of this event have not been quantified. We present a case in which late spontaneous recanalization of long-lasting middle cerebral artery occlusion occurred in the absence of surgical, endovascular and thrombolytic treatments.
Angiography ; Arteries ; Incidence ; Infarction, Middle Cerebral Artery ; Middle Cerebral Artery

No abstract available.
Brain ; Brain Neoplasms ; Cerebral Infarction ; Infarction, Middle Cerebral Artery ; Middle Cerebral Artery ; Vasospasm, Intracranial

No abstract available.
Ataxia* ; Cerebellar Ataxia ; Infarction* ; Middle Cerebral Artery*

Hyperintense vessels are frequently observed on fluid-attenuated inversion recovery imaging in acute ischemic stroke patients. Some investigators suggest that a hyperintense vessel sign in patients with middle cerebral arterial occlusion results from collateral blood flow originating in neighboring arterial territories, especially via pial collaterals. We report two cases of acute proximal middle cerebral arterial infarction that exhibited hyperintense vessels signs on fluid-attenuated inversion recovery imaging accompanying pial collaterals as confirmed by cerebral angiography.
Cerebral Angiography ; Cerebral Infarction ; Collateral Circulation ; Glycosaminoglycans ; Humans ; Infarction ; Infarction, Middle Cerebral Artery ; Middle Cerebral Artery ; Research Personnel ; Stroke

The spot sign refers to tiny enhanced foci within the hematoma on a brain computed tomography angiography image. A spot sign is usually considered to be associated with hematoma progression in patients with acute intracerebral hemorrhage. We describe a patient with infarction of the left middle cerebral artery where a spot sign was observed. A spot sign may also have significant predictive value for large hemorrhagic transformation in patients with ischemic stroke.
Angiography* ; Brain* ; Cerebral Hemorrhage ; Cerebral Infarction ; Hematoma ; Humans ; Infarction ; Infarction, Middle Cerebral Artery* ; Middle Cerebral Artery ; Stroke

Spontaneous dissection of the middle cerebral artery could result in thromboembolic stroke caused by the intramural hematoma. Dissection should be considered as a possible etiology in a young stroke patient, but it is not straightforward in an emergency situation. Moreover, the efficacy and safety of thrombolytic treatment in the acute stage are unknown. We applied intravenous and intra-arterial stent thrombectomy with the Solitaire device successfully in a patient with acute left middle cerebral artery occlusion due to spontaneous dissection.
Emergencies ; Hematoma ; Humans ; Infarction* ; Infarction, Middle Cerebral Artery ; Middle Cerebral Artery* ; Stents* ; Stroke ; Thrombectomy*

PURPOSE: To describe the imaging findings at susceptibility weighted imaging (SWI) at 3T in patients with occlusion of middle cerebral artery, and to correlate the absence or presence of arterial bright foci in sylvian fissure, as one of their finding at SWI, with the diffusion weighted imaging (DWI) scores. MATERIALS AND METHODS: We included 12 patients with symptomatic unilateral occlusion of middle cerebral artery. Retrospective review of SWI and DWI was done. On DWI, size of infarction was analyzed according to the ASPECTS grading system. On SWI, presence of hemorrhage, dark blooming of intravascular clot, distension of medullary or cortical vein, and absence or presence of bright arterial foci in sylvian fissure were evaluated. RESULTS: Of 12 patients with symptomatic unilateral MCA occlusion, SWI showed dark blooming of intravascular clot in 8 patients (66.7%), distended medullary or cortical vein in 7 patients (58.3%), nonvisualization of arterial bright signal intensity in sylvian fissure in 7 patients (58.3%), and hemorrhage in one patient (8.3%). In comparison with DWI, patients with sylvian arterial bright signal intensity showed better ASPECTS score (6.4+/-4.1) than patients without arterial bright signal intensity (4.4+/-1.1), yet it was not statistically significant (p=0.267, t-test). CONCLUSION: SWI at 3T provides added diagnostic information including site of occlusion, collateral flow by arterial bright signal intensity in sylvian fissure and early hemorrhagic transformation in patients with symptomatic MCA occlusion.
Diffusion ; Hemorrhage ; Humans ; Infarction ; Infarction, Middle Cerebral Artery ; Middle Cerebral Artery ; Retrospective Studies ; Stroke ; Veins