Cerebral infarction of different blood supplied areas caused by middle cerebral artery stenosis and occlusion:a contrast study

Objective To investigate the pathogenesis of middle cerebral artery(MCA) stenosis and occlusion caused cerebral infarction by a contrast study on atherosclerotic stenosis and occlusion of the main stem of MCA caused cerebral infarction in different MCA blood supplied areas and to provide evidence for the relative therapeutic strategies.Methods The clinical and imaging data of 61 patients with fresh cerebral infarction caused by atherosclerotic MCA stenosis(stenosis 50%) and occlusion were analyzed retrospectively.The patients were divided into stenosis group(n=27) and occlusion group(n=34).The locations of cerebral infarction were determined and compared according to the results of MRI diffusion-weighted imaging(DWI) within one week after onset.Results Single infarction in the stenosis and occlusion groups were 15(55.6%) and 8(23.5%) patients,respectively,and the multiple infarctions in the two groups were 12(44.4%) and 26(76.5%) patients,respectively(P0.05).Among the patients with single infarctions,the small perforating artery infarct(SPAI) in the stenosis and occlusion groups were 11(11/15) and 2(2/8) patients(P=0.039);among the patients with multiple infarctions,the perforating artery infarct(PAI) complicated with cortical infarction(pial infarct,PI) were 7(7/12) and 3(3/26) patients(P=0.005); among the patients with multiple infarctions,PAI complicated with PI and border-zone infarct(BZI) were 1(1/12) and 16(16/26) patients(P=0.004);there were 5 and 23 patients with BZI(P0.001).Conclusions The sites of cerebral infarction caused by atherosclerotic stenosis and occlusion of main-stem of MCA has significant difference.It is suggested that there are different pathogenesis between them.Cerebral infarction caused by MCA stenosis may be resulted from the ostial lesion of the perforating artery and embolism.The former caused more single infarctions and the latter caused more multiple infarctions.