Isolated Middle Cerebral Artery Stenotic Disease

J Korean Neurol Assoc > Volume 17(6); 1999 > Article

Journal of the Korean Neurological Association 1999;17(6): 785-791.

고립 중대뇌동맥 협착성 질환

성강주, 신원철 장대일 정경천

경희대학교 의과대학 신경과학교실

Isolated Middle Cerebral Artery Stenotic Disease

Kang Ju Sung, M.D., Won Chul Shin, M.D., Dae-Il Chang, M.D., Kyung-Cheon Chung, M.D.

Department of Neurology, College of Medicine, Kyung Hee University

Abstract

Background : Middle cerebral artery (MCA) steno-occlusive disease is known to be more common in Eastern than in Western, however, clinical characteristics have not been well documented. We aimed to find clinical characteristics of isolated MCA disease comparing with other MCA steno-occlusive disease. M e t h o d s : Patients with lesion in M1 portion of MCA divided into three groups by angiographic finding ; isolated MCA stenosis (IMCAS, n=39), isolated MCA occlusion (IMCAO, n=29), and multiple (ICA, BA or VA) steno-occlusion involving MCA (Combined, n=48). Patients with evidence of cardioembolic MCA occlusion and Moyamoya disease were excluded. We analyzed clinical features, neuroimaging findings, and prognosis retrospectively. R e s u l t s : MRI showed large deep (36%), small deep (26%), cortical (21%), and mixed (cortical & deep, 15%) infarct in IMCAS group ; mixed (38%), large deep (21%), small deep (17%), and cortical (17%) infarct in IMCAO group ; large deep (31%), cortical (23%), small deep (17%), and no lesion (17%) in Combined group. Site of MCA steno-occlusion on angiogram was middle (44%), distal (39%), and proximal (18%) in IMCAS group ; proximal (48%), middle (35%), and distal (17%) in IMCAO group ; middle (42%), proximal (31%), and distal (27%) in Combined group. Patient’s neurologic status, assessed by NIHSS, during first 7 days was ‘not changed’ or ‘worsening’ (>93%) in all 3 groups. Neurologic outcome at 3 months later was improving (65%) in IMCAS group by modified Rankin scale. C o n c l u s I o n s : Isolated MCA stenotic disease was not significantly different from iso-lated MCA occlusion group or Combined group in clinical features, neuroimaging findings, and prognosis. J Korean Neurol Assoc 17(6):785~791, 1999 Key Words : Middle cerebral artery, Isolated middle cerebral artery stenosis, Isolated middle cerebral artery occlusion