Dominant Ipsilateral Posterior Cerebral Artery on Magnetic Resonance Angiography in Acute Ischemic Stroke

2004 ◽  
Vol 18 (2) ◽  
pp. 91-97 ◽  
Author(s):  
Ju-Hun Lee ◽  
Sun-Jung Han ◽  
Woo-Youl Kang ◽  
Ki Hyeong Lee ◽  
Kyung-Ho Yu ◽  
...  
2021 ◽  
pp. 174749302110483
Author(s):  
Ida Rangus ◽  
Lennart S Milles ◽  
Ivana Galinovic ◽  
Kersten Villringer ◽  
Heinrich J Audebert ◽  
...  

Background Variants of the Circle of Willis (vCoW) may impede correct identification of ischemic lesion patterns and stroke etiology. We assessed reclassifications of ischemic lesion patterns due to vCoW. Methods We analyzed vCoW in patients with acute ischemic stroke from the 1000+ study using time-of-flight magnetic resonance angiography (TOF MRA) of intracranial arteries. We assessed A1 segment agenesis or hypoplasia in the anterior circulation and fetal posterior cerebral artery in the posterior circulation. Stroke patterns were classified as one or more-than-one territory stroke pattern. We examined associations between vCoW and stroke patterns and the frequency of reclassifications of stroke patterns due to vCoW. Results Of 1000 patients, 991 had evaluable magnetic resonance angiography. At least one vCoW was present in 37.1%. VCoW were more common in the posterior than in the anterior circulation (33.3% vs. 6.7%). Of 238 patients initially thought to have a more-than-one territory stroke pattern, 20 (8.4%) had to be reclassified to a one territory stroke pattern after considering vCoW. All these patients had fetal posterior cerebral artery and six (30%) additionally had carotid artery disease. Of 753 patients initially presumed to have a one-territory stroke pattern, four (0.5%) were reclassified as having more-than-one territory pattern. Conclusions VCoW are present in about one in three stroke patients and more common in the posterior circulation. Reclassifications of stroke lesion patterns due to vCoW occurred predominantly in the posterior circulation with fetal posterior cerebral artery mimicking multiple territory stroke pattern. Considering vCoW in these cases may uncover symptomatic carotid disease.


2018 ◽  
Vol 8 ◽  
pp. 19 ◽  
Author(s):  
Betty Simon ◽  
Sunithi Elizabeth Mani ◽  
Shyamkumar Nidugala Keshava ◽  
Mathew Alexander ◽  
Sanjith Aaron

Aim: To determine the accuracy of transcranial color-coded Doppler sonography (TCCS) in the evaluation of cerebral arterial system in patients with ischemic stroke attending a tertiary care hospital in South India. Objectives: (1) To describe the topographical distribution of atherosclerotic lesions in the cerebral circulation in patients presenting with ischemic stroke from the Indian subcontinent and (2) to determine the accuracy of TCCS for detection and quantification of intracranial stenoses in various segments of the intracerebral arterial system in comparison with magnetic resonance angiography (MRA). Materials and Methods: The demographic profile and risk factors of consecutive patients who presented to neurology outpatient department with cerebral ischemia and scheduled for MRA were determined. These patients had undergone neck Doppler, TCCS, and MRA. The agreement between the MRA and TCCS was assessed using kappa statistics. The sensitivity, specificity, and positive and negative predictive values of TCCS as compared to MRA were calculated. Results: Ninety patients were included in the final analysis. Intracranial atherosclerosis was found in 35.6% of cases. The agreement between TCCS and MRA in detecting lesions for the different arterial segments in the intracranial circulation was 0.83 for anterior cerebral artery (ACA), 0.66 for M1 segment of middle cerebral artery (MCA), 0.45 for M2 segment of MCA, 0.86 for terminal internal carotid artery (TICA), 0.46 for posterior cerebral artery (PCA), and 0.81 for vertebral artery (VA). The sensitivity for the detection of hemodynamically significant arterial lesions in different vascular segments was 100%, 70%, 33.3%, 90.9%, 33.3%, and 72.7% for ACA, M1, M2, TICA, PCA, and VA, respectively. Conclusion: Intracranial atherosclerosis was found to be the predominant distribution of cerebral atherosclerosis. TCCS is a safe method for evaluation of proximal basal cerebral arteries in the intracranial circulation with relatively better sensitivity in the anterior circulation.


2016 ◽  
Vol 117 (1) ◽  
pp. 305-307 ◽  
Author(s):  
Laurens Hermie ◽  
Jeroen De Groote ◽  
Bert Geerts ◽  
Peter Vanlangenhove

2012 ◽  
Vol 34 (5) ◽  
pp. 396-399 ◽  
Author(s):  
Toshiki Takenouchi ◽  
Sachiko Shimozato ◽  
Hirokazu Fujiwara ◽  
Suketaka Momoshima ◽  
Takao Takahashi

1991 ◽  
Vol 1 (2) ◽  
pp. 100-102
Author(s):  
Daniel H. Golwyn ◽  
Carlos A. Cardenas ◽  
F. Reed Murtagh ◽  
Stephen M. Sergay

2001 ◽  
Vol 11 (4) ◽  
pp. 363-368 ◽  
Author(s):  
Li-Ming Lien ◽  
Wei-Hung Chen ◽  
Jiunn-Rong Chen ◽  
Hou-Chang Chiu ◽  
Yuh-Feng Tsai ◽  
...  

2018 ◽  
Vol 14 (3) ◽  
pp. 290-297 ◽  
Author(s):  
Haruna Miyazawa ◽  
Tatsunori Natori ◽  
Hiroyuki Kameda ◽  
Makoto Sasaki ◽  
Hideki Ohba ◽  
...  

Background Recent advances in high-resolution (HR) magnetic resonance angiography (MRA) using ultrahigh-field systems enable direct visualization of the lenticulostriate arteries (LSAs), which had been hardly achieved by conventional MRA. Hence, by using HR-MRA at 7 T, we attempted to assess occlusive changes in the LSAs in patients with LSA territorial infarcts. Methods We prospectively examined 34 consecutive patients with acute ischemic stroke in the LSA territory using a 7 T scanner. We measured the lengths of the relevant LSAs on HR-MRA and the diameters/volume of the infarcts and compared these between the patients with/without occlusive changes in the LSAs. Results On HR-MRA, occlusion of the LSAs was observed in 19 (59%) of 32 patients who were eligible for the analyses. The curved/straight lengths of the LSAs in the patients with LSA occlusion (23.1–31.1/17.8–24.3 mm) were significantly shorter than in those without apparent LSA occlusion (25.8–39.5/24.0–30.4 mm) ( P = 0.027/0.003). The anteroposterior/superoinferior diameters of the infarcts were significantly larger in the occluded-LSA group (14.5–21.4/14.9–22.2 mm) than in the intact-LSA group (10.9–16.8/10.8–16.2 mm) ( P = 0.041/0.011). In addition, the curved lengths of the relevant LSAs showed significant correlations with the superoinferior diameters of the infarcts ( r = 0.38, P = 0.034). Conclusion Occlusive changes in the LSAs were frequently found in patients with acute ischemic stroke within the LSA territory when using HR-MRA at 7 T and were substantially related to superoinferior extension of the infarcts.


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