This Article Full Text Full Text (PDF) All Versions of this Article: 36/5/986    most recent 01.STR.0000163087.66828.e9v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Phan, T. G. Articles by Reutens, D. C. Search for Related Content PubMed PubMed Citation Articles by Phan, T. G. Articles by Reutens, D. C. Related Collections Emergency treatment of Stroke Computerized tomography and Magnetic Resonance Imaging

(Stroke. 2005;36:986.)
© 2005 American Heart Association, Inc.

Original Contributions

A Digital Map of Middle Cerebral Artery Infarcts Associated With Middle Cerebral Artery Trunk and Branch Occlusion

From the Neuroimaging Division (T.G.P., G.A.D., P.M.W., D.C.R.), National Stroke Research Institute and The University of Melbourne, Austin & Repatriation Medical Centre, Melbourne, Australia; Monash Institute of Neurological Diseases (D.C.R.), Monash Medical Centre, Melbourne, Australia.

Correspondence to Dr David C. Reutens, MD, FRACP, Monash Institute of Neurological Diseases, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria, Australia. E-mail david.reutens{at}med.monash.edu.au

Background and Purpose— Knowledge of the topographic distribution of infarcts of the middle cerebral artery (MCA) may give insight into the limits of the arterial territory and infarct mechanism and may influence the decision to use thrombolytic therapy. We describe the creation of a digital atlas of MCA (DA-MCA) infarction associated with MCA branch and trunk occlusion using magnetic resonance (MR) techniques.

Methods— Hemispheric infarcts, with evidence of MCA trunk or branch occlusion, were manually segmented into binary images, linearly registered into a common stereotaxic coordinate space, and averaged to yield the probability of involvement by infarction at each voxel. Comparisons were made with existing maps of the MCA territory.

Results— Twenty-eight patients with median age of 74 years (range, 26 to 87 years) were studied. On the DA-MCA, the highest frequency of infarction was within the striatocapsular region, centrum semiovale, and the insula. The mean and maximal MCA infarct volumes were 195.5 cm³ and 366.3 cm³, respectively. Comparison with published maps showed that the most common difference from the DA-MCA was in the superomedial extent of the MCA territory. Some maps showed the MCA territory reaching the interhemispheric fissure, whereas in the DA-MCA it did not. There was a lower variability in the anterior boundary of the MCA territory compared with its posterior counterpart.

Conclusion— We have created a digital atlas of MCA infarction using MR imaging techniques. This approach may be useful to establish the distribution of the MCA and other arterial territories and the border zones between them with greater certainty.

Key Words: magnetic resonance imaging • middle cerebral artery • stroke

This article has been cited by other articles:

				S.-J. Kim, I.-J. Kim, Y.-K. Kim, T.-H. Lee, J. S. Lee, S. Jun, H.-Y. Nam, J. S. Lee, Y. K. Kim, and D. S. Lee Probabilistic Anatomic Mapping of Cerebral Blood Flow Distribution of the Middle Cerebral Artery J. Nucl. Med., January 1, 2008; 49(1): 39 - 43. [Abstract] [Full Text] [PDF]

				T. G. Phan, MBBS, FRACP, A. C. Fong, G. Donnan, and D. C. Reutens Digital Map of Posterior Cerebral Artery Infarcts Associated With Posterior Cerebral Artery Trunk and Branch Occlusion Stroke, June 1, 2007; 38(6): 1805 - 1811. [Abstract] [Full Text] [PDF]

				T. G. Phan, V. Srikanth, and D. C. Reutens Borderzone Infarction: Stroke Topography Does Not Easily Equate With Stroke Mechanism Stroke, November 1, 2006; 37(11): 2658 - 2658. [Full Text] [PDF]

				C. J.S. Price, D. Wang, D. K. Menon, J. V. Guadagno, M. Cleij, T. Fryer, F. Aigbirhio, J.-C. Baron, and E. A. Warburton Intrinsic Activated Microglia Map to the Peri-infarct Zone in the Subacute Phase of Ischemic Stroke Stroke, July 1, 2006; 37(7): 1749 - 1753. [Abstract] [Full Text] [PDF]

				M. Bergui, G. B. Bradac, D. M. Johnson, and D. C. Kramer Intra-arterial Thrombolysis in Late Pregnancy Stroke, March 1, 2006; 37(3): 764 - 765. [Full Text] [PDF]