A review of the anatomy of the middle cerebral artery for the era of thrombectomy: A radiologic tool based on CT angiography and perfusion CT

2021 ◽  
Vol 63 (6) ◽  
pp. 505-511
Author(s):  
S. Medrano-Martorell ◽  
M. Pumar-Pérez ◽  
S. González-Ortiz ◽  
J. Capellades-Font
Keyword(s):  
Middle Cerebral Artery ◽  
Ct Angiography ◽  
Cerebral Artery ◽  
Perfusion Ct

Assessment of Collateral Circulation Using Perfusion CT in Middle Cerebral Artery Thrombectomy-Treated Patients

2020 ◽  
Vol 29 (7) ◽  
pp. 104805
Author(s):  
Santiago Trillo ◽  
María Carmen Ramos ◽  
Clara Aguirre ◽  
José Luis Caniego ◽  
Eduardo Bárcena ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Collateral Circulation ◽  
Perfusion Ct

scholarly journals Optimal Brain Perfusion CT Coverage in Patients with Acute Middle Cerebral Artery Stroke

2009 ◽  
Vol 31 (4) ◽  
pp. 691-695 ◽  
Author(s):  
A.D. Furtado ◽  
B.C. Lau ◽  
E. Vittinghoff ◽  
W.P. Dillon ◽  
W.S. Smith ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Brain Perfusion ◽  
Perfusion Ct ◽  
Middle Cerebral Artery Stroke

scholarly journals Prediction of Malignant Middle Cerebral Artery Infarction Using Computed Tomography-Based Intracranial Volume Reserve Measurements

Stroke ◽  
2011 ◽  
Vol 42 (12) ◽  
pp. 3403-3409 ◽  
Author(s):  
Jens Minnerup ◽  
Heike Wersching ◽  
E. Bernd Ringelstein ◽  
Walter Heindel ◽  
Thomas Niederstadt ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Predictive Value ◽  
Perfusion Ct ◽  
Lesion Volume ◽  
Intracranial Volume ◽  
Ischemic Lesion ◽  
Predictive Values ◽  
Malignant Infarction ◽  
Malignant Mca Infarction

Background and Purpose— Early decompressive surgery in patients with malignant middle cerebral artery (MCA) infarction improves outcome. Elevation of intracranial pressure depends on both the space occupying brain edema and the intracranial volume reserve (cerebrospinal fluid [CSF]). However, CSF volume was not investigated as a predictor of malignant infarction so far. We hypothesize that assessment of CSF volume in addition to admission infarct size improves early prediction of malignant MCA infarction. Methods— Stroke patients with carotid-T or MCA main stem occlusion and ischemic lesion (reduced cerebral blood volume [CBV]) on perfusion CT were considered for the analysis. The end point malignant MCA infarction was defined by clinical signs of herniation. Volumes of CSF and CBV lesion were determined on admission. Receiver-operator characteristics analysis was used to calculate predictive values for radiological and clinical measurements. Results— Of 52 patients included, 26 (50%) developed malignant MCA infarction. Age, a decreased level of consciousness on admission, CBV lesion volume, CSF volume, and the ratio of CBV lesion volume to CSF volume were significantly different between malignant and nonmalignant groups. The best predictor of a malignant course was the ratio of CBV lesion volume to CSF volume with a cut-off value of 0.92 (96.2% sensitivity, 96.2% specificity, 96.2% positive predictive value, and 96.2% negative predictive value). Conclusions— Based on admission native CT and perfusion CT measurements, the ratio of ischemic lesion volume to CSF volume predicts the development of malignant MCA infarction with higher accuracy than other known predictors, including ischemic lesion volume or clinical characteristics.

Usefulness of Preoperative Three-Dimensional Computed Tomographic Angiography With Two-Dimensional Computed Tomographic Imaging for Rupture Point Detection of Middle Cerebral Artery Aneurysms

2008 ◽  
Vol 62 (suppl_1) ◽  
pp. ONS126-ONS133 ◽  
Author(s):  
Kojiro Wada ◽  
Hirohiko Arimoto ◽  
Hidenori Ohkawa ◽  
Toshiki Shirotani ◽  
Yohsitaro Matsushita ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Ct Angiography ◽  
Cerebral Artery ◽  
Three Dimensional ◽  
Ct Image ◽  
Two Dimensional ◽  
Computed Tomographic ◽  
Transsylvian Approach ◽  
Risk Of Rupture ◽  
Middle Cerebral Artery Aneurysms

Abstract Objective: We report the technique of three-dimensional computed tomographic (CT) angiography with a two-dimensional CT image aiding in the early operation of ruptured middle cerebral artery aneurysms. This combined image allows the prediction of the rupture point in the aneurysm and may reduce the risk of rupture during early clipping surgery. Methods: The findings for 14 patients with 14 middle cerebral artery ruptured aneurysms who underwent subsequent early clipping were analyzed. The average aneurysm size was 8.5 mm, and there were two large and one giant aneurysms. CT examinations were performed by means of a multidetector CT scanner (Aquilion M16; Toshiba Medical Systems, Tokyo, Japan) and reconstructed with a workstation (ZIO M900 QUADRA; Amin Co., Ltd., Tokyo, Japan). We constructed an operating view through three-dimensional CT angiography for a lateral transsylvian approach with a two-dimensional CT image (nonshaded volume-rendering image), which was perpendicular to the direction of the surgical approach. Using this combined image, we predicted the rupture point of the aneurysm and successfully performed clipping surgery through a lateral transsylvian approach. Rupture points were confirmed at the time of surgery. Rupture points of 13 out of 14 aneurysms appeared as we expected, but one differed; all aneurysms were successfully clipped. Thirteen of the 14 patients could be clipped without rupture at surgery, but the remaining patient experienced rupture just after craniotomy. Conclusion: The combination of three-dimensional CT angiography and two-dimensional CT images may help improve the surgical outcome by indicating aneurysmal rupture points, leading to the prevention of rupture.

Three-dimensional helical computerized tomography angiography in the diagnosis, characterization, and management of middle cerebral artery aneurysms: comparison with conventional angiography and intraoperative findings

2002 ◽  
Vol 97 (6) ◽  
pp. 1322-1332 ◽  
Author(s):  
J. Pablo Villablanca ◽  
Parizad Hooshi ◽  
Neil Martin ◽  
Reza Jahan ◽  
Gary Duckwiler ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Treatment Planning ◽  
Ct Angiography ◽  
Computerized Tomography ◽  
Cerebral Artery ◽  
Three Dimensional ◽  
Content Type ◽  
Computerized Tomography Angiography ◽  
Fine Print

Object. Middle cerebral artery (MCA) aneurysms can be difficult to detect and characterize. The authors describe the utility and impact of helical computerized tomography (CT) angiography for the evaluation of aneurysms in this location, and compare this modality with digital subtraction (DS) angiography and intraoperative findings. Methods. Two hundred fifty-one patients with suspected cerebral aneurysms underwent CT angiography. Two-dimensional multiplanar reformatted images and three-dimensional CT angiograms were examined by two independent readers in a blinded fashion. Results were compared with findings on DS angiograms to determine the relative efficacy of these modalities in the detection and characterization of aneurysms. Questionnaires completed by neurosurgeons and endovascular therapists were used to determine the impact of CT angiograms on aneurysm management. Twenty-eight patients harboring 31 MCA aneurysms and 26 patients without aneurysms were identified using CT angiography. The sensitivity of CT angiography and DS angiography for MCA aneurysms was 97%; both techniques showed 100% specificity. In 76% of evaluations, the CT angiography studies provided information not available on DS angiography examinations. For the characterization of aneurysms, CT angiography was rated superior (72%) or equal (20%) to DS angiography in 92% of cases evaluated (p < 0.001). Computerized tomography angiography was evaluated as the only study needed for patient triage in 82% of cases (p < 0.001), and as the only study needed for treatment planning in 89% of surgically treated (p < 0.001) and in 63% of endovascularly treated cases (p < 0.001). The information acquired on CT angiograms changed the initial treatment plan in 24 (67%) of these 36 complex lesions (p < 0.01). The aneurysm appearance intraoperatively was identical or nearly identical to that seen on CT angiograms in 17 (89%) of 19 of the surgically treated cases. Conclusions. Computerized tomography angiography has unique advantages over DS angiography and is a viable alternative to the latter modality in the diagnosis, triage, and treatment planning in patients with MCA aneurysms.

Accuracy of perfusion-CT inpredicting malignant middle cerebral artery brain infarction

2008 ◽  
Vol 255 (6) ◽  
pp. 896-902 ◽  
Author(s):  
R. Dittrich ◽  
S. P. Kloska ◽  
T. Fischer ◽  
E. Nam ◽  
M. A. Ritter ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Brain Infarction ◽  
Perfusion Ct

scholarly journals Mismatch between TOF MR Angiography and CT Angiography of the Middle Cerebral Artery may be a Critical Sign in Cerebrovascular Dynamics

2018 ◽  
Vol 59 (1) ◽  
pp. 80 ◽  
Author(s):  
Keiji Igase ◽  
Michiya Igase ◽  
Ichiro Matsubara ◽  
Kazuhiko Sadamoto
Keyword(s):  
Middle Cerebral Artery ◽  
Ct Angiography ◽  
Cerebral Artery ◽  
Mr Angiography
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