Computed tomography of cerebral infarction along the distribution of the basal perforating arteries. Part II: Thalamic arterial group.

Abstract

Computed tomographic (CT) manifestations of cerebral infarction along the distribution of the basal perforating arteries were reviewed and correlated with cerebral angiography. Infarcts in the territories of perforators were demonstrated individually based on knowledge of their three-dimensional distribution as shown by microangiography of cadavers. In Part II of the study, the posterior areas supplied by the thalamic arteries were examined. Infarcts in the area supplied by the thalamotuberal arteries involved the anterior pole of the thalamus; those in the area of the thalamoperforate arteries involved the medial portion of the thalamus, along the lateral wall of the third ventricle; those in the area of the thalamogeniculate arteries involved the posterolateral portion of the thalamus; and those in the area of the choroidal arteries of the lateral ventricle involved the most posterolateral and dorsolateral portions of the thalamus. Clinical and neuroradiological correlations are discussed.

Artery of Percheron Infarction: Imaging Patterns and Clinical Spectrum

“…Other smaller studies have demonstrated the AOP ischemic pattern in 2% of all ischemic strokes 24 and from 4% to 18% of all thalamic strokes. 4,9,19,24,25 The AOP is rarely visualized with conventional angiography, and to our knowledge, only 3 other authors have successfully demonstrated this variant. 18,26,27 We were able to capture a striking image of the AOP with conventional angiography in 1 of our patients (Fig 6).…”

“…[1][2][3][4][5][6][7][8] The paramedian arteries have great variability with respect to number, size, and territorial contribution to the thalamus. 1,2,6,[9][10][11][12][13] Many authors have demonstrated that the paramedian arteries can supply both the paramedian and the anterior thalamic territories, especially when the polar artery is absent. 1,4,6,9,10,[14][15][16][17][18][19] The variable presence of the polar artery (absent in 30%-60% of the population) 7,15,16 is not surprising because it arises from the PcomA, which itself is highly variable and can be absent or hypoplastic.…”

“…1,2,6,[9][10][11][12][13] Many authors have demonstrated that the paramedian arteries can supply both the paramedian and the anterior thalamic territories, especially when the polar artery is absent. 1,4,6,9,10,[14][15][16][17][18][19] The variable presence of the polar artery (absent in 30%-60% of the population) 7,15,16 is not surprising because it arises from the PcomA, which itself is highly variable and can be absent or hypoplastic. One case series reported 7 of 8 bilateral paramedian thalamic infarcts extended into the anterior thalamic territory of the polar artery.…”

“…Thus, the paramedian arteries often supply the rostral midbrain. 4,9,14,[20][21][22] The focus of this article is the specific ischemic patterns that result from occlusion of an anatomic variant of the paramedian arteries called the AOP. 4 The AOP is an uncommon anatomic variant, in which a single dominant thalamoperforating artery supplies the bilateral medial thalami with variable contribution to the rostral midbrain (Fig 1).…”

Spatial Functional Distribution in the Corticospinal Tract at the Corona Radiata: A Three-dimensional Anisotropy Contrast Study.

“…The low incidence of lower extremity-dominant motor dysfunction may reflect the supply of the posterior part of the corona radiata by the perforating arteries from the posterior communicating artery, whereas the anterior part is supplied by the lenticulostriate arteries. 9, 40) Our patients with corticospinal tract injury in the middle one third showed little recovery in the upper extremity but marked recovery in the lower extremity at follow up, indicating that the middle one third of the corticospinal tract at the level of the corona radiata is strongly correlated with upper extremity motor function. Similarly, our findings also suggest that the posterior one third of the corticospinal tract is involved in lower extremity motor function.…”