Syndromes of Occlusions of Middle Cerebral Artery Branches

Waddington, Margaret M.; Ring, B. Albert

doi:10.1093/brain/91.4.685

Cited by 42 publications

(10 citation statements)

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“…In severe MCAS the total length of stenosis was 6.8 mm (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) and the length of maximal stenosis was 2.9 mm (0. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. An ulcer was suggested only in 5 of the 142 (4%) severely stenosed middle cerebral artery where this finding could be evaluated (76%).…”

Section: Angiographk Featuresmentioning

confidence: 99%

Atherosclerotic disease of the middle cerebral artery.

Bogousslavsky¹,

Barnett²,

Aj³

et al. 1986

Stroke

200

107

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SUMMARY Three hundred and fifty-two patients with atherosclerotic middle cerebral artery stenosis (MCAS, 53%) or occlusion (MCAO, 47%) have been systematically studied. The study involved all patients entered into the EC/IC Bypass Study with isolated MCA disease or a tandem lesion predominating in the MCA ipsilateral to the ischemic events (18 patients with a tandem lesion of greater magnitude in the internal carotid artery were not included). The Asian patients represented 58% of all Asians entered into the EC/IC Bypass Study, whereas the white patients represented 18% of all whites and the black patients 34% of all blacks. Isolated TIAs were less frequent in MCAO (12%) than in MCAS (34%). Warning TIAs before a stroke occurred in one third of the cases. Presentation with stroke or isolated TIA was not influenced by sex, age, level of MCA obstruction, collateral circulation nor associated carotid disease. In MCAS, no major difference in presentation was found between severe and moderate stenosis. Pure motor hemiparesis occurred in 15% and pure sensory stroke in 2% of the patients with stroke and 30% of the MCA territory infarcts were small and limited to the lentkulocapsular area, confirming that so-called lacunar infarcts may be due to large vessel disease.During follow-up (42 months) of 164 medically-treated patients, further cerebrovascular events (TIA and stroke) occurred in 11.7% of the patients per year. In MCAO the stroke rate was 10.1 % per patient-year and the ipsilateral infarct rate was 7.1% per patient-year. In MCAS, the stroke rate was 9.5% per patientyear and the ipsilateral stroke rate was 7.8% per patient-year. The location and severity of lesion did not influence the occurrence of ipsilateral ischemic events during follow-up. Reopening of an artery-to-artery embolic occlusion of the MCA, with subsequent embollc reocclusion, may explain some of the ipsilateral ischemic events during follow-up. The annual death rate was 3.3% in MCAS and 2.6% in MCAO. Less than 15% of the survivors were severely disabled at the end of follow-up and nearly two-thirds were able to resume previous activities both hi MCAO and MCAS. The type of delayed ischemic events tended to be the same as that of the presenting event, but no factor could significantly predict the occurrence of stroke or death. This study suggests that long-term prognosis of patients with MCA occlusion, who present with TIA or non-devastating stroke, is reasonable.

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Section: Angiographk Featuresmentioning

confidence: 99%

Atherosclerotic disease of the middle cerebral artery.

Bogousslavsky¹,

Barnett²,

Aj³

et al. 1986

Stroke

200

107

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“…O fato de a maioria dos pacientes apresentarem comprometimento no lobo parietal e hemiplegia pode ser justificado pelo comprometimento mais frequente no território da artéria cerebral média, o que acometeu em 70% dos pacientes deste estudo 30 .…”

Section: Discussionunclassified

Síndrome de Pusher em Pacientes com AVC e Sua Associação com Gravidade Clínica e Dependência Funcional

Palmini¹,

Costa

Grave

2013

RNC

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original RESUMOObjetivo. Estabelecer a prevalência da síndrome de Pusher (SP) em pacientes após acidente vascular cerebral (AVC) a partir da Scale for Contraversive Pushing (SCP -avaliação do sintoma de empurrar) e correlacioná-la com anormalidades do exame neurológico, gravidade do AVC e funcionalidade. Método. Estudo transversal com amostra de conveniência, diagnóstico de AVC agudo, clinicamente estáveis e com possibilidade de avaliação da severidade do evento através da escala National Institute of Health Stroke Scale (NIHSS) e do Índice de Barthel (IB). Para o diagnóstico da SP, utilizou-se dois critérios de pontuação, com diferentes pontos de corte, na SPC: resultado maior ou igual a um (critério I) ou maior que zero (critério II). Resultados. 30 foram incluídos no estudo. As médias do NIHSS e do IB foram de 8,5 e 48,8 pontos, respectivamente. A presença de SP associou--se significativamente a valores mais baixos no IB quando se utilizou o critério II (22,5±8,5 versus 58,4±27,3; P<0,001). Conclusão. A prevalência da SP em paciente pós-AVC agudo é significativa e pode variar de acordo com os critérios utilizados. Sua presença associa-se a parâmetros clínicos de maior gravidade e dependência funcional, maior incidência do evento em AVC isquêmico, lobo parietal e artéria cerebral média.Unitermos. Acidente Vascular Cerebral, Hemiplegia, Postura, Reabilitação.Citação. Palmini S, Costa J, Grave M. Síndrome de Pusher em Pacientes com AVC e Sua Associação com Gravidade Clínica e Dependência Funcional. ABSTRACTObjective. To establish the prevalence of pusher syndrome (PS) in patients after stroke from clinical criteria contained in Scale for Contraversive Pushing (CPS -evaluation of the symptom of pushing), and correlate them with neurological abnormalities, severity of stroke and functionality. Method. a cross-sectional study with convenience sample of patients of both sexes with a diagnosis of acute stroke. We included clinically stable patients and that were able to assess the severity of the event from the range of National Institute of Health Stroke Scale (NIHSS) and BI. To diagnose the pusher syndrome we used two scoring criteria with different cutoff points in the Scale for Contraversive Pushing: result greater than or equal to 1 (criterion I) or greater than zero (criterion II). Results. 86 patients were evaluated. Mean NIHSS and Barthel index were 8.5 and 48,8 points respectively. The presence of PS was significantly associated with lower values when the Barthel scale, we used the criterion II (22.5±8.5 versus 58.4±27.3, P<0.001). Conclusion. The prevalence of PS in patients after acute stroke is significant and can vary according to the criteria used. Its presence is associated with clinical severity and functional dependence, higher incidence in ischemic stroke event, parietal lobe and middle cerebral artery, respectively.

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“…Therefore, the commonest event is that the MCA divides into anterior and posterior branches that supply most of the lateral surface of the cerebral hemisphere. Because of this variable vascular anatomy, the clinical picture of MCA occlusion is highly variable and may be isolated to a specific area—for example, complete proximal main stem occlusion, deep arterial territory infarction or superficial cortical (anterior or posterior) syndromes 3 4…”

Section: Discussionmentioning

confidence: 99%

The striatocapsular infarction and its aftermaths

Amin¹,

Zangana

Ameen

2010

Case Reports

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Ischaemic stroke syndromes in the vascular territory of middle cerebral artery may have atypical presentation and radiographic findings because of the variable anatomy of that artery. Therefore, misdiagnosis of these syndromes as neoplastic or infectious processes is not uncommon. This case describes a 69-year-old comatose woman who was referred to us as having 'a brain tumour with massive surrounding oedema.' Further work-up revealed that she had a large left-sided lenticular nuclear infarction with some extension into the surrounding areas-the striatocapsular infarction.

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Syndromes of Occlusions of Middle Cerebral Artery Branches

Cited by 42 publications

References 0 publications

Atherosclerotic disease of the middle cerebral artery.

Atherosclerotic disease of the middle cerebral artery.

Síndrome de Pusher em Pacientes com AVC e Sua Associação com Gravidade Clínica e Dependência Funcional

The striatocapsular infarction and its aftermaths

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