The striatocapsular infarction and its aftermaths

Amin, Osama Shukir Muhammed; Zangana, Hero M; Ameen, Nawa A

doi:10.1136/bcr.02.2010.2703

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…Generally they are divided into medial (having a lumen of 100-200 μ) and lateral (with a lumen of 200-400 μ) groups (15). The putamen, parts of the globus pallidus, body of caudate, claustrum, and anterior and posterior limbs of internal capsules are nourished by the lateral lenticulostriate arteries which 5)stem of the posterior and superior aspect of the main stem of the middle cerebral artery (some minor contribution comes from Heubner’s artery and anterior choroidal arteries) (17). When these arteries are obstructed altogether, they result in the so-called striatocapsular infarction (SCI) which has been defined as a comma-shaped softening in the area of the basal ganglia of at least 3 cm in length and 1 cm in width (5).…”

Section: Discussionmentioning

confidence: 99%

Striatocapsular Infarction; a Single Institutional Experience

Amin¹,

Abdullah²,

Xaznadar³

et al. 2012

Acta Inform Med

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Objective:Striatocapsular infarction is an uncommon form of deep hemispheric strokes. We analyzed the clinical presentation of this stroke to determine its core features and neurological outcome.Material and methods:This prospective, observational, short-term longitudinal study was carried out from November 1, 2009 to October 30, 2011 in the department of neurology, Sulaimaniya general teaching hospital, Iraq and involved 13 consecutive Kurdish patients who were diagnosed with striatocapsular infarction radiologically; all patients underwent routine blood tests, resting 12-lead ECG, transthoracic echocardiography, and urgent non-contrast CT brain scanning at the time of admission. All patients were reassessed clinically after 3 months.Results:Nine patients (69%) were females and 7 patients (53%) were older than 50 years of age. Infarction of the right lenticular nucleus was more common than the left one. Severe flaccid hemiplegia dominated the clinical presentation. Speech and language dysfunction were found in 4 patients (30%) while inattention and neglect were detected in 8 patients (61%). At 3 months, 4 patients were bed-ridden and 4 were wheel-chair bound; dystonia and involuntary movements did not occur. Only the patient with bilateral infarction demonstrated Parkinsonism.Conclusion:Striatocapsular infraction in Iraqi Kurdish patients was more common in females and at the right lenticular nucleus. Hypertension, smoking, and hypercholesterolemia were the commonest risk factors. Dense hemiplegia was the commonest presentation; the functional outcome was poor in the majority. After 3 months of the ischemic event, involuntary movements and dystonia were not seen, and Parkinsonism was found in one patient only.

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Section: Discussionmentioning

confidence: 99%

Striatocapsular Infarction; a Single Institutional Experience

Amin¹,

Abdullah²,

Xaznadar³

et al. 2012

Acta Inform Med

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“…When the lateral lenticulostriate arteries become blocked, striatocapsular infarction ensures (1)(2)(3)(4). This is defined as a an inverted comma-shaped softening in the area of the basal ganglia of at least 3 cm in length and 1 cm in width (1,2).…”

Section: Discussionmentioning

confidence: 99%

Striatocapsular infarction and acquired stuttering

Amin¹

2014

Gaziantep Med J

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Striatocapsular infarction may result in a multitude of language and speech disturbances. Acquired stuttering is a rare speech disorder that occurs as an aftermath of this stroke syndrome. We report on the case of 6o-yearold right-handed woman who presented with acute right-sided hemiparesis and stuttering. Language assessment revealed intact comprehension, naming, reading and writing. When the patient spoke spontaneously, there were frequent initial prolongations with repetition of initial syllables. There was no word-finding difficulty or paraphasia. Her stuttering improved remarkably after few weeks but persistent in a very mild degree. Acute striatocapsular infarction-induced acquired stuttering is rare. It may be a transient event and generally holds a good prognosis. It can occur without subcortical aphasia or dysarthria. Keywords: Striatocapsular infarction; acquired stuttering; speech disorder Özet Striatokapsüler enfarktüs bir çok dil ve konuşma bozukluklarına neden olabilmektedir. Edinilmiş kekemelik bu inme sendromunun ardından ortaya çıkan nadir bir konuşma bozukluğudur. Akut sağ-taraflı hemiparezi ve kekemelik ile başvuran 60 yaşındaki sağ el-dominant bir kadın vakayı sunmaktayız. Dil değerlendirmesinde anlama, adlandırma, okuma ve yazma intakt saptandı. Hasta spontan konuştuğunda ilk hecelerin tekrarı ile uzatması saptandı. Parafazi ya da kelime bulmakta güçlük yoktu. Kekemeliği birkaç hafta sonra belirgin olarak iyileşti ancak çok hafif derecede kaldı. Akut striatokapsüler enfarktüs kaynaklı edinilmiş kekemelik nadir olup, prognozu genellikle iyi olup, geçicidir. Subkotikal afazi ya da dizartri olmaksızın da oluşabilir.

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“…However, radiologically, the patient had developed right-sided striatocapsular infarction (SCI), which is defined as a comma-shaped infarction at the basal ganglia area of at least 3 cm in length and 1 cm in width1 as a result of occlusion of the lateral lenticulostriate arteries which stem off the posteriolateral surface of the MCA's main stem 2. The overlying cortical areas are spared; although the maximum ischaemia is found at the depth of the hemisphere, but several patients (including ours) demonstrate cortical signs (such as hemineglect).…”

Section: Descriptionmentioning

confidence: 99%

Acute dysarthria, dense left hemiparesis and left sensory neglect: is it striatocapsular infarction?

Amin

2012

BMJ Case Reports

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DESCRIPTIONA 52-year-old right-handed hypertensive patient presented with sudden onset of dense flaccid left-sided weakness. There was atrial fibrillation, dysarthria, moderate leftsided facial weakness, left sensory hemineglect and left extensor planter. Her CT brain scan showed a hypodense comma-shaped area at the right basal ganglia. Her brain MRI (figure 1) and MR angiography (figure 2) were obtained on day 2 of admission.Clinically, the patient seemed to have developed an embolic stroke of the main stem of the right middle cerebral artery (MCA) and one might expect that the whole cerebral territory supplied by the right MCA would have been infarcted. However, radiologically, the patient had developed right-sided striatocapsular infarction (SCI), which is defined as a comma-shaped infarction at the basal ganglia area of at least 3 cm in length and 1 cm in width 1 as a result of occlusion of the lateral lenticulostriate arteries which stem off the posteriolateral surface of the MCA's main stem.2 The overlying cortical areas are spared; although the maximum ischaemia is found at the depth of the hemisphere, but several patients (including ours) demonstrate cortical signs (such as hemineglect). A compromise in the overlying cortical areas, that is not seen by conventional imaging studies, was the suggested mechanism behind the development of cortical signs. In most patients, dense hemiplegia occurs; the arm weakness is usually more severe than the leg, and this ratio usually persists upon recovery.3 SCI of the nondominant hemisphere can result in subcortical dysarthria or hypophonia and hypokinetic speech. Figure 1 Axial T2-weighted MRI of our patient with right-sided striatocapsular infarction at the level of basal ganglia on day 2 of admission. Note the right-sided hyperintense comma-shaped sign that represents the infarcted right putamen-globus pallidus, anterior limb of internal capsule and part of the head of caudate. On the T1-weighted image, this 'comma' appears hypointense. The adjacent thalamus and the overlying cortical areas are 'normal-looking'. The normal left putamen-globus pallidus (yellow arrow), anterior limb of internal capsule (black arrow) and caudate's head (red arrow) were labelled for comparison. Figure 2 Coronal section of the patient's brain magnetic resonance angiography, who had developed right-sided striatocapsular infarction. Note that the right middle cerebral artery becomes non-visualised suddenly, just beyond its origin (yellow arrow) when compared with the left one (red arrow).

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The striatocapsular infarction and its aftermaths

Cited by 4 publications

References 13 publications

Striatocapsular Infarction; a Single Institutional Experience

Striatocapsular Infarction; a Single Institutional Experience

Striatocapsular infarction and acquired stuttering

Acute dysarthria, dense left hemiparesis and left sensory neglect: is it striatocapsular infarction?

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