Single best answer (SBA)
Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon in Radiology for Undergraduate Finals and Foundation Years, 2018
A 67-year-old man presents with left leg weakness with reduced sensation and milder, predominantly distal, left arm weakness. CT head shows low attenuation within the right medial frontal and parietal lobes. To which arterial territory does this correspond? Anterior cerebral artery.Middle cerebral artery.Posterior cerebral artery.Vertebral artery.Superior cerebellar artery.
Head, neck and vertebral column
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
The vertebral artery (from the subclavian, runs cranially up through the foramina in the transverse processes of the upper six cervical vertebrae) enters the skull through the foramen magnum and unites with its fellow to form the single midline basilar artery, which lies on the ventral (anterior) surface of the pons. It divides into the two posterior cerebral arteries - each is joined by the posterior communicating artery to the internal carotid where that vessel divides into its two main branches. The internal carotid artery terminates as the middle cerebral artery (which runs laterally in the lateral sulcus to emerge on the lateral surface of the cerebral cortex) and the anterior cerebral artery (which is united to its fellow by the very short anterior communicating artery and runs on to the medial surface of the cerebral hemisphere). Anterior and middle cerebral vascular lesions cause paralysis; posterior cerebral lesions cause visual defects. Apart from cortical, brainstem and cerebellar branches, there are very small but highly important striate branches of the anterior and middle cerebral arteries that penetrate the brain substance to supply the internal capsule (p. 45).
Cerebrovascular Disease
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
The anterior cerebral artery is far less often affected than the middle cerebral artery, although the causes are similar. However, anterior cerebral territory infarction should raise the level of awareness for unusual aetiologies. It also occurs secondary to vasospasm after SAH. The clinical features of anterior cerebral artery occlusion are a contralateral hemiplegia in which the leg is more affected than the arm, because the cortical representation of the leg lies within its territory. Infarction of subfrontal cortex, especially if bilateral, may cause frontal neuropsychological deficits, particularly executive dysfunction, abulia, disinhibition and lack of insight, often without any other signs.
Comparison of radiological versus clinical cerebral vasospasm after aneurysmal subarachnoid hemorrhage: is vasospasm always present?
Published in Neurological Research, 2020
Djula Djilvesi, Igor Horvat, Bojan Jelaca, Jagos Golubovic, Filip Pajicic, Petar Vulekovic
Control CTA findings were analyzed independently by a radiologist and researcher. Data about the presence, region and intensity of vasospasm were determined by radiologist comparing control and admission CTA findings, without exact measuring the blood vessels. Researcher measured seven segments of the proximal blood vessels of the brain in their distal parts at admission and control CTA: 1. suprasellar part of the Internal carotid artery; 2. M1 segment of the Medial cerebral artery; 3. A1 segment of the Anterior cerebral artery; 4. A2 segment of the Anterior cerebral artery; 5. P1 segment of the Posterior cerebral artery; 6. vertebral artery, and 7. basilar artery. If there were signs of vasospasm in distal circulation (M2 and M3), these data were noted and taken into account in statistical analysis. In determining the presence of vasospasm, findings by both a radiologist and researcher were taken into account. The presence of cerebral vasospasm was classified as: 1. present (degree of narrowing of the blood vessel 5–100%, taking into account the possibility of error in the measurement) and 2. absent (0–5% narrowing). Narrowing of the arteries on angiographic images on the basis of the measured values was classified into: 1. mild (5–33%); 2. moderate (34–66%), and 3. severe (67–100%).
Impact of visual impairment following stroke (IVIS study): a prospective clinical profile of central and peripheral visual deficits, eye movement abnormalities and visual perceptual deficits
Published in Disability and Rehabilitation, 2022
Fiona J. Rowe, Lauren R. Hepworth, Claire Howard, Kerry L. Hanna, Jim Currie
Visual acuity is a primary measure of central visual function. The majority (81.4%) of stroke survivors needed glasses and wore their current glasses for visual acuity assessments. The mean near and distance visual acuities were below cut-off levels of low vision defined by the World Health Authority [20] and, by default, below levels acceptable for driving according to international driving regulations [21,28]. Our findings are similar to other studies reporting reduced central vision with reports of 15–25% at logMAR levels worse than 0.5 [29,30]. New onset reduced central vision may be due to stroke-related impact to the visual pathway. Arterial blood supply to the retina is from the central retinal artery – a branch from the anterior cerebral artery. Healthy vascular perfusion of the retina, and particularly the foveal and macular areas, is essential to high level central vision [2]. It is feasible that reduced central vision following stroke may reflect reduced perfusion and relative ischaemia within the anterior visual pathway. Visual field loss was predominantly homonymous hemianopia and quadrantanopia as is frequently reported [31–34].
Stenosis length of middle cerebral artery and branch atheromatous disease associated infarct
Published in International Journal of Neuroscience, 2018
Jian Wang, Yujie Wang, Zijia Chai, Yue Xin, Jialiang Wang, Jianting Qiu
On the whole, the branch arteries include recurrent artery of Heunber from anterior cerebral artery (ACA), lenticulostriate arteries from middle cerebral artery (MCA) and anterior choroidal artery from internal carotid artery (ICA) in the anterior cerebral circulatory system. Due to the high prevalence and easy identification, the lenticulostriate arteries are the mostly studied. Lenticulostriate arteries originate from the M1 segment of MCA. The M1 segment is classically defined as extending to the insular branches, including the bifurcation of the MCA [12], but it was recently recommended that M1 should be defined as extending from the carotid terminal segment to the first bifurcation of the MCA [13]. Lenticulostriate arteries supply basal ganglia, corona radiate and internal capsule. They stem from MCA separately or in common trunk with others [14,15].
Related Knowledge Centers
- Anterior Communicating Artery
- Cerebral Arteries
- Circle of Willis
- Internal Carotid Artery
- Superior Parietal Lobule
- Frontal Lobe
- Stroke
- Lobes of The Brain
- Circle of Willis
- Anterior Cerebral Artery Syndrome
- Paresis