Anatomical distribution and clinical significance of middle cerebral artery M2 segment vessel occlusions and its cortical branches in acute ischaemic stroke patients.
ANATOMY
CEREBROVASCULAR DISEASE
INTERVENTIONAL
STROKE
Journal
BMJ neurology open
ISSN: 2632-6140
Titre abrégé: BMJ Neurol Open
Pays: England
ID NLM: 101775450
Informations de publication
Date de publication:
2023
2023
Historique:
received:
15
04
2023
accepted:
28
06
2023
medline:
17
7
2023
pubmed:
17
7
2023
entrez:
17
7
2023
Statut:
epublish
Résumé
Characterisation of anatomical distribution and the clinical impact of middle cerebral artery M2 (MCA-M2) segment occlusion and its subsequent cortical branches (CBs) in acute ischaemic stroke patients (AIS). Retrospective, monocentric study analysing radiological and clinical data of AIS patients with MCA-M2 segment occlusion with regard to the anatomic distribution of MCA-M2 occlusion and its subsequent CB. A total of 203 patients (median age 77 (IQR 66-83) years, 112 women) were included. There was an equal distribution of right-sided versus left-sided MCA-M2 vessel occlusions (right: n=97; left: n=106), as well as with a median number of affected MCA-M2 CBs of 4 (IQR, 3-6) and a median National Institute of Health Stroke Scale score (NIHSS) on admission of 9 (3-15). For both hemispheres, CBs of the inferior trunks were significantly more affected than the superior trunks. Endovascular treatment (EVT, n=94) was associated with a significant better outcome compared with patients with medical management alone (p=0.027). In acute MCA-M2 segment occlusions, inferior trunks are significantly more affected compared with the superior trunks. The subsequent CBs of the paracentral region of both hemispheres are more commonly involved. In eloquent vascular territories, EVT was more often performed.
Sections du résumé
Background
UNASSIGNED
Characterisation of anatomical distribution and the clinical impact of middle cerebral artery M2 (MCA-M2) segment occlusion and its subsequent cortical branches (CBs) in acute ischaemic stroke patients (AIS).
Methods
UNASSIGNED
Retrospective, monocentric study analysing radiological and clinical data of AIS patients with MCA-M2 segment occlusion with regard to the anatomic distribution of MCA-M2 occlusion and its subsequent CB.
Results
UNASSIGNED
A total of 203 patients (median age 77 (IQR 66-83) years, 112 women) were included. There was an equal distribution of right-sided versus left-sided MCA-M2 vessel occlusions (right: n=97; left: n=106), as well as with a median number of affected MCA-M2 CBs of 4 (IQR, 3-6) and a median National Institute of Health Stroke Scale score (NIHSS) on admission of 9 (3-15). For both hemispheres, CBs of the inferior trunks were significantly more affected than the superior trunks. Endovascular treatment (EVT, n=94) was associated with a significant better outcome compared with patients with medical management alone (p=0.027).
Conclusion
UNASSIGNED
In acute MCA-M2 segment occlusions, inferior trunks are significantly more affected compared with the superior trunks. The subsequent CBs of the paracentral region of both hemispheres are more commonly involved. In eloquent vascular territories, EVT was more often performed.
Identifiants
pubmed: 37457626
doi: 10.1136/bmjno-2023-000450
pii: bmjno-2023-000450
pmc: PMC10347505
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e000450Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
AJNR Am J Neuroradiol. 2016 Apr;37(4):667-72
pubmed: 26564442
Clin Neuroradiol. 2020 Sep;30(3):481-487
pubmed: 31338541
AJNR Am J Neuroradiol. 2017 Jan;38(1):84-89
pubmed: 27765740
J Neurointerv Surg. 2020 Aug;12(8):768-773
pubmed: 32107286
J Neurosurg. 1981 Feb;54(2):151-69
pubmed: 7452329
Neurointervention. 2019 Sep;14(2):137-141
pubmed: 31401819
J Neurointerv Surg. 2018 Jul;10(7):620-624
pubmed: 29127196
J Neurointerv Surg. 2016 Dec;8(12):1273-1277
pubmed: 26863104
JAMA Neurol. 2014 Feb;71(2):151-7
pubmed: 24323077
Stroke. 2019 Feb;50(2):419-427
pubmed: 31287757
Clin Neuroradiol. 2020 Jun;30(2):339-343
pubmed: 30788520
J Cerebrovasc Endovasc Neurosurg. 2021 Sep;23(3):193-200
pubmed: 34492752
J Neurointerv Surg. 2019 Nov;11(11):1065-1069
pubmed: 30975736
J Neurointerv Surg. 2021 Jul;13(7):623-630
pubmed: 33637570
Neurol India. 2005 Jun;53(2):186-90
pubmed: 16010057
Stroke. 2019 Dec;50(12):e344-e418
pubmed: 31662037