2010 Volume 32 Issue 4 Pages 325-333
Background and purpose: Striatocapsular infarction (SCI) has been well recognized as subcortical infarcts mainly corresponding to the region of lenticulostriate arteries. Stroke mechanisms are mostly associated with embolic mechanisms and less frequently with middle cerebral atherothrombotic disease (MCAD). Although intracranial atherosclerosis is prevalent in Japan, SCI caused by MCAD has not yet been systematically studied. We therefore conducted the present study to elucidate the stroke mechanism of SCI caused by MCAD.
Subjects and methods: We selected 56 patients who had middle cerebral artery occlusion or stenosis, and classified patients into 3 groups: 1. 10 patients with pure SCI, 2. 5 with SCI plus, 3. 41 with non-SCI.
Results: Progressive motor deficits were found in 5 patients with pure SCI (50%), 3 with SCI plus (60%) and 17 with non-SCI (41%). Severe disability expressed by modified Rankin Scale on discharge was found in 9 patients with pure SCI (90%), 3 with SCI plus (60%) and 23 with non-SCI (56%). Middle cerebral artery occlusion was found in 7 patients and stenosis was found in 3 patients in the SCI group.
Conclusions: Patients with pure SCI and SCI plus exhibited a higher prevalence of progressive motor deficits and severe disability as compared to non-SCI. Three patients with SCI appeared to be caused by middle cerebral artery stenosis, and we speculated that penetrating arteries were occluded by atherothrombolic plaque. As SCI often shows neurological deterioration in the acute stage, the precise mechanism of infarcts should be further explored and intensive treatment should be tailored.
