title: Atherothrombotic lesion of the middle cerebral artery: report of 21 cases with stenotic and obstructive lesions.
abstract: This was a retrospective analysis of 12 consecutive cases of middle cerebral artery stenosis and 9 consecutive cases of middle cerebral artery occlusion that presented to our hospital with acute cerebral ischemia. The degree and area of the cerebral infarctions were assessed with the Alberta Stroke Program Early CT Score (ASPECTS) and ASPECTS-DWI (APSECTS with assessment of white matter lesion using diffusion-weighted image). As for cerebral infarctions in the region of the perforating artery, lesions that were more than 20 mm long in the caudal-cranial direction were diagnosed as branch atheromatous disease (BAD). Activities of daily living (ADL) were poorer in the cases with lower ASPECTS and ASPECTS-DWI. ADL tended to be worse in cases with BAD than in those without. The prognosis was significantly poorer in the group with ASPECTS< or =7 points. ASPECTS tended to be lower in cases with BAD than in those without. ADL, ASPECTS and the presence of BAD were not significantly different between the stenosis and obstruction groups. In summary, the neurological prognosis was dependent on the extent of the cerebral infarction and was related to BAD to some extent. These findings will be important when considering medical treatment at the outpatient clinic setting.
authors.affiliation: Department of Neurosurgery, Ogaki Municipal Hospital, Ogaki, Japan. oya3776@arrow.ocn.ne.jp
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Oyama
authors.forename: Akira
authors.initials: A
authors.lastname: Kito
authors.forename: Hideki
authors.initials: H
authors.lastname: Maki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hattori
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Noda
authors.forename: Kentaro
authors.initials: K
authors.lastname: Wada
mesh_terms: D000203:Activities of Daily Living; D050197:Atherosclerosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D016009:Chi-Square Distribution; D038524:Diffusion Magnetic Resonance Imaging; D004185:Disability Evaluation; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D020767:Intracranial Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed
references.citation: Rinsho Shinkeigaku. 2010 Nov;50(11):919-20
references.pmid: 21921510
references.citation: Neurology. 1989 Sep;39(9):1246-50
references.pmid: 2671793