Lee Kyung Bok, Oh Hyung Geun, Roh Hakjae, Ahn Moo Young
Department of Neurology, Soonchunhyang University, College of Medicine, Seoul, Korea.
Eur Neurol. 2008;60(2):79-84. doi: 10.1159/000136652. Epub 2008 Jun 5.
The aims of our study were to elucidate the differences in the distribution of acute middle cerebral artery (MCA) infarctions involving the striatocapsular region and to compare those following embolic striatocapsular infarctions with those originating from MCA disease (MCAD).
We prospectively enrolled patients with acute large infarcts located in the lenticulostriate artery territory. Brain coronal diffusion-weighted imaging (DWI) and magnetic resonance angiography were carried out in all patients. The types of infarct distribution were divided into 3 categories: (1) dominant in the distal territory (DD), (2) distributed equally between the distal and proximal territories (DE) and (3) dominant in the proximal territory. Stroke mechanisms were classified into stroke from proximal embolism, MCAD and stroke of undetermined etiology.
A total of 71 patients were recruited. Proximal embolic sources were significantly more prevalent in patients with a DE lesion, but symptomatic MCA stenoses were more common in patients with a DD lesion than in those with a DE lesion.
These results suggest that the dominant area of striatocapsular infarctions on coronal DWI can be an important clue for stroke etiology.
我们研究的目的是阐明累及纹状体囊区的急性大脑中动脉（MCA）梗死分布的差异，并比较栓塞性纹状体囊梗死与源自大脑中动脉疾病（MCAD）的梗死情况。
我们前瞻性纳入了位于豆纹动脉区域的急性大面积梗死患者。所有患者均进行了脑冠状位扩散加权成像（DWI）和磁共振血管造影。梗死分布类型分为3类：（1）以远段区域为主（DD），（2）远段和近段区域分布均等（DE），（3）以近段区域为主。卒中机制分为近端栓塞性卒中、MCAD和病因不明的卒中。
共纳入71例患者。近端栓塞源在DE病变患者中显著更为常见，但DD病变患者中症状性MCA狭窄比DE病变患者更常见。
这些结果表明，冠状位DWI上纹状体囊梗死的优势区域可能是卒中病因的重要线索。
