Cerebral infarcts related to isolated middle cerebral artery stenosis.
OBJECTIVE
The clinical presentation of middle cerebral artery (MCA) stenosis, a rarely diagnosed condition, is not well known. The aim of this study was to analyze the stroke patterns of patients with isolated MCA stenosis.


METHODS
Twenty-two patients with cerebral infarcts due to isolated MCA stenosis were analyzed with respect to their clinical syndrome, and cerebral lesions were assessed by neuroimaging. MCA stenosis was diagnosed by transcranial Doppler sonography (TCD) in 16, by TCD and digital subtraction angiography (DSA) in 4, and by DSA alone in 2 patients.


RESULTS
Ten patients (45.5%) had lacunar syndromes, suggesting small-vessel disease, and 12 patients (55.5%) showed signs and symptoms of cortical dysfunction. Cerebral CT or MRI showed no lesion in 2 patients, small deep infarcts in 10, large striatocapsular infarcts in 2, combined piomedullary and striatocapsular infarcts in 4, piomedullary branch infarcts in 3, and MCA trunk infarct in 1.


CONCLUSIONS
The results suggest an association between MCA stenosis and (1) lacunar infarcts and (2) the occurrence of piomedullary MCA branch infarcts alone or in combination with subcortical infarcts. The clinical syndromes and the radiological findings correspond in most cases.
Lyrer
P A
PA
Department of Neurology, University Hospital Basel, Switzerland. LYRER@ubaclu.unibas.ch
Engelter
S
S
Radü
E W
EW
Steck
A J
AJ
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D002533:Cerebral Angiography; D002536:Cerebral Arteries; D002544:Cerebral Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017585:Ultrasonography, Doppler, Transcranial