Cerebral Infarcts Related to Isolated Middle Cerebral Artery Stenosis

• DOI: 10.1161/01.str.28.5.1022
• Publication Date: 2011-06-17T20:08:03Z
• Authors: P. A. Lyrer; S. Engelter; E. W. Radü; A. J. Steck
• Keywords: Adult; Male; Ultrasonography, Doppler, Transcranial; Angiography, Digital Subtraction; Arterial Occlusive Diseases; Cerebral Infarction; Constriction, Pathologic; Cerebral Arteries; Middle Aged; Magnetic Resonance Imaging; Cerebral Angiography; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Aged

Background and Purpose The clinical presentation of middle cerebral artery (MCA) stenosis, a rarely diagnosed condition, is not well known. The aim of this study was to analyze the stroke patterns of patients with isolated MCA stenosis.

Methods Twenty-two patients with cerebral infarcts due to isolated MCA stenosis were analyzed with respect to their clinical syndrome, and cerebral lesions were assessed by neuroimaging. MCA stenosis was diagnosed by transcranial Doppler sonography (TCD) in 16, by TCD and digital subtraction angiography (DSA) in 4, and by DSA alone in 2 patients.

Results Ten patients (45.5%) had lacunar syndromes, suggesting small-vessel disease, and 12 patients (55.5%) showed signs and symptoms of cortical dysfunction. Cerebral CT or MRI showed no lesion in 2 patients, small deep infarcts in 10, large striatocapsular infarcts in 2, combined piomedullary and striatocapsular infarcts in 4, piomedullary branch infarcts in 3, and MCA trunk infarct in 1.

Conclusions The results suggest an association between MCA stenosis and (1) lacunar infarcts and (2) the occurrence of piomedullary MCA branch infarcts alone or in combination with subcortical infarcts. The clinical syndromes and the radiological findings correspond in most cases.