Preferred Involvement of the Basal Ganglia After Lenticulostriate Infarction as a Possible Indicator of Different Gray and White Matter Vulnerability

Nagakane, Yoshinari; Yamada, Kazuo; Ohara, Tomoyuki; Yoshikawa, Kunihiko; Kuriyama, Nagato; Takayasu, Natsuko; Kasai, Takashi; Yuki, Natsuko; Mizuno, Toshiki; Nakagawa, Masanori

doi:10.1161/strokeaha.107.484337

Cited by 10 publications

(7 citation statements)

References 5 publications

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“…M1 occlusion may lesion the pyramidal tract as it forms the IC dorsal genu and posterior limb (between the caudate body and putamen), but these regions are supplied by the most lateral LS arteries. Moreover, observations in our patients show that IC involvement is much less consistent than involvement of the striatum, presumably reflecting that white matter has greater ischemic tolerance than gray matter 28. That more proximal MCA occlusions regularly lead to more extensive striatal infarctions provides an alternative explanation for the reportedly poorer outcome26 27 of these patients.…”

Section: Discussionmentioning

confidence: 49%

Lenticulostriate infarctions after successful mechanical thrombectomy in middle cerebral artery occlusion

Kleine

Beller

Zimmer

et al. 2016

J NeuroIntervent Surg

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Section: Discussionmentioning

confidence: 49%

Lenticulostriate infarctions after successful mechanical thrombectomy in middle cerebral artery occlusion

Kleine

Beller

Zimmer

et al. 2016

J NeuroIntervent Surg

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“…Proposed mechanisms include selective vulnerability of gray matter to ischemia, embolic phenomena involving independent lenticulostriate arteries for gray and white matter, or variation in tissue oxygen consumption of the basal ganglia and internal capsule. 8 Most strokes affecting the basal ganglia do not produce HC-HB suggesting unique predisposing factors for this rare clinical phenotype. 9 Advanced age, female gender, Asian ethnicity, vascular stenosis, and medical comorbidities (eg, uncontrolled diabetes mellitus) may predispose to poststroke HC-HB.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Resolution of Acute Onset Hemichorea–Hemiballismus After Treatment With Intravenous Tissue Plasminogen Activator

McCollum

Dawson

Barrett

2012

The Neurohospitalist

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Hyperkinetic movement disorders are uncommon after acute ischemic stroke. Since these movement disorders are rarely the initial manifestation of acute cerebral ischemia, their presence may result in diagnostic uncertainty or it may inappropriately delay intravenous thrombolytic therapy for ischemic stroke. Hemichorea-hemiballism (HC-HB) is one of the more frequently encountered hyperkinetic movement disorders occurring in conjunction with stroke. Although HC-HB may result from a stroke mimic, the acute onset should prompt rapid evaluation and consideration for the presence of stroke along with its time-dependent therapies including recombinant tissue plasminogen activator (rtPA). In this article, we describe a case of a patient with acute cerebral ischemia presenting clinically with HC-HB, who was given intravenous rtPA therapy despite an initially negative, early diffusion-weighted magnetic resonance imaging (MRI). Follow-up brain MRI performed 24 hours after the initiation of thrombolytic therapy confirmed acute infarction in the contralateral striatum. The patient had near-complete resolution of her HC-HB on discharge and had no complications related to the administration of intravenous rtPA.

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“…Based on this result, the corticospinal tract may be less involved and that the possibility of NW development is low [19,20]. Since vascular occlusion sites determine the extent of lesion growth, proximal occlusion may result in a wider ischemic area than distal occlusion [21,22,23].…”

Section: Discussionmentioning

confidence: 99%

Lesion Patterns of Small Deep Infarcts Have Different Clinical and Imaging Characteristics

et al. 2010

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Background: The mechanisms underlying small deep infarcts in the subcortical area are unknown. This study used coronal diffusion-weighted imaging (DWI) to investigate clinical and radiological findings in patients with small deep infarcts. Methods: This was a retrospective study of consecutively admitted patients with small deep infarcts in the subcortical area. We divided the patients into two groups as follows: (1) those with isolated lesion (IL) defined as an IL in the parenchyma by coronal DWI (group A), and (2) those with linear lesion (LL), defined as a LL extending to the basal surface on coronal DWI (group B). Results: A total of 86 patients were included in this study, with 43 patients in each group. Neurological decline and ipsilateral MCA stenosis were observed more frequently in group B than in group A. Fluid-attenuated inversion recovery (FLAIR) signals showed that white-matter hyperintensity was more severe in group A than in group B (p = 0.015). Conclusions: This study suggests that LL patterns of small deep infarcts may result in a higher rate of neurological decline and ipsilateral MCA stenosis than IL patterns.

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Preferred Involvement of the Basal Ganglia After Lenticulostriate Infarction as a Possible Indicator of Different Gray and White Matter Vulnerability

Abstract: Background and Purpose-Symptomatic

Cited by 10 publications

References 5 publications

Lenticulostriate infarctions after successful mechanical thrombectomy in middle cerebral artery occlusion

Lenticulostriate infarctions after successful mechanical thrombectomy in middle cerebral artery occlusion

Resolution of Acute Onset Hemichorea–Hemiballismus After Treatment With Intravenous Tissue Plasminogen Activator

Lesion Patterns of Small Deep Infarcts Have Different Clinical and Imaging Characteristics

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