alexa Infarct Patterns in the Middle Cerebral Artery Territory and Their Association with Large Artery Stenosis
ISSN: 2329-6895

Journal of Neurological Disorders
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Research Article

Infarct Patterns in the Middle Cerebral Artery Territory and Their Association with Large Artery Stenosis

Martin Osorio Flores1, Y Swamy Venkatesh2*, Ambika Rao3 and Michael Brooks4
1Department of Neurology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
2Department of Neurology, University of South Carolina School of Medicine, Philadelphia, Pennsylvania, USA
3Department of Medicine, Dorn VAMC, Columbia, SC, Philadelphia, Pennsylvania, USA
4Department of Neuroradiology, Mercy Catholic Medical Center, Philadelphia, Pennsylvania, USA
Corresponding Author : Y Swamy Venkatesh
Department of Neurology
University of South Carolina School of Medicine
8 Medical Park, Suite 420, Columbia, SC 29203, USA
Tel: 803-545-6050
Fax: 803-545-6051
E-mail: [email protected]
Received March 18, 2014; Accepted April 29, 2014; Published May 03, 2014
Citation: Flores MO, Venkatesh YS, Rao A and Brooks M (2014) Infarct Patterns in the Middle Cerebral Artery Territory and Their Association with Large Artery Stenosis. J Neurol Disord 2:159. doi: 10.4172/2329-6895.1000159
Copyright: © 2014 Flores MO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Background and Purpose: We investigated the association between critical stenosis of the internal carotid artery or the first segment of the middle cerebral artery and patterns of cerebral infarcts classified by their territorial distribution.

Methods: This cross-sectional study included patients with diffusion-weighted magnetic resonance-confirmed acute/early subacute infarcts in the middle cerebral artery territory who underwent head/neck magnetic resonance angiography. We grouped infarct patterns in two categories: shower/cortical watershed/superficial perforating territory and complete middle cerebral artery/cortical territorial/deep perforating territory.

Results: Seventeen and 33 patients, respectively, presented with shower/cortical watershed/superficial perforating territory infarcts and complete middle cerebral artery/cortical territorial/deep perforating territory infarcts. Eleven (64.7%) of the former and five (15.2%) of the latter had critical stenosis of the internal carotid artery or the first segment of the middle cerebral artery. A strong statistical association favoring the presence of critical stenosis in the shower/cortical watershed/superficial perforating territory group (P=.001) persisted on logistic regression analysis (P=.002).

Conclusions: The occurrence of diffusion-weighted magnetic resonance-confirmed acute/early subacute middle cerebral artery infarcts in the shower/cortical watershed/superficial perforating territory distribution is strongly associated with the presence of critical stenosis of the internal carotid artery or the first segment of the middle cerebral artery. Further prospective studies are needed to address the significance of this finding.

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