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Middle Cerebral Artery Stenosis Is a Major Clinical Determinant in Striatocapsular Small, Deep Infarction
Oh Young Bang, MD;
Ji Hoe Heo, MD;
Jung Yeon Kim, MD;
Jae Hyun Park, MD;
Kyoon Huh, MD
Arch Neurol. 2002;59:259-263.
Background The significance of the stenotic lesions of the middle cerebral artery
(MCA) in Asian patients with striatocapsular small, deep infarctions (SSDIs)
remains undetermined.
Objectives To investigate the frequency of stenotic lesions of the MCA in patients
with SSDIs and to evaluate clinical and radiological features in those same
patients.
Setting Acute stroke registry of a university hospital.
Patients and Methods One hundred two Korean patients with acute symptomatic SSDIs underwent
cerebral angiography or magnetic resonance angiography and echocardiography.
We divided these patients into 2 groups—patients with and without MCA
occlusive lesions. The clinical and magnetic resonance image features were
compared between these 2 groups.
Results Thirty-seven patients (36%) had an ipsilateral proximal MCA lesion,
whereas 65 patients (64%) showed no MCA abnormality on cerebral angiography
or magnetic resonance angiography. Among 65 patients without an MCA lesion,
18 had an embolic source; the remaining 37 patients had no demonstrable embolic
source. There were significant differences in the temporal profile and magnetic
resonance imaging findings between the groups. Although the type of lacunar
syndrome and the volume of infarcts did not differ between the groups, the
unstable temporal profile and magnetic resonance imaging findings of multiple
small infarcts in the symptomatic hemisphere were frequently observed in patients
with MCA lesions.
Conclusions The proximal MCA lesion was a common cause of SSDIs in Korean patients.
Depending on the existence of an MCA lesion, the clinical course and magnetic
resonance imaging feature of the patients with SSDIs were different.
From the Departments of Neurology, College of Medicine, Ajou University,
Suwon (Drs Bang and Huh); College of Medicine, Yonsei University, Seoul (Dr
Heo); and the College of Medicine, InJe University, Seoul (Drs Kim and Park),
South Korea.
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