CT-defined large subcortical infarcts: correlation of location with site of cerebrovascular occlusive disease.
OBJECTIVE
To correlate the location of large subcortical infarcts with the site of cerebrovascular occlusive disease.


METHODS
We examined CT and angiographic findings of 38 patients with major arterial occlusive disease and newly developed large subcortical infarcts of 2.0 cm or more, which were classified into three types: striatocapsular infarcts in the basal ganglia, terminal supply area infarcts in the corona radiata, and terminal supply area infarcts in the centrum semiovale.


RESULTS
Two or three of the types of infarct were sometimes combined; the combination of the striatocapsular and corona radiata infarcts was the most frequent (14 [36.8%] of 38). Thirty-four (89.5%) had atherosclerotic major arterial occlusive diseases; 22 (57.9%) had occlusive diseases of the internal carotid artery, and 12 (31.6%) had diseases of the middle cerebral artery. The other 4 (10.5%) had embolic transient middle cerebral artery occlusion. Middle cerebral artery occlusive diseases frequently produced striatocapsular (13 [81.3%] of 16) and corona radiata (13 [81.3%] of 16) infarcts but never induced the centrum semiovale lesions. On the other hand, in patients with internal carotid artery occlusive disease, the centrum semiovale (16 [72.7%] of 22) was more susceptible to ischemia than the striatocapsular region (11 [50%] of 22) or the corona radiata (9 [40.9%] of 22).


CONCLUSIONS
Middle cerebral artery occlusive diseases frequently produced striatocapsular and/or corona radiata infarcts but never induced the centrum semiovale lesions, which were usually associated with internal carotid artery occlusive diseases.
Nakano
S
S
Department of Neurosurgery, Junwakai Memorial Hospital, Komatsu, Japan.
Yokogami
K
K
Ohta
H
H
Goya
T
T
Wakisaka
S
S
D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000098:blood supply; D001480:Basal Ganglia Diseases / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000000981:diagnostic imaging*; D002552:Cerebral Ventricles / Q000098:blood supply; D003342:Corpus Striatum / Q000098:blood supply; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed