Analysis on cerebral infarction mode in middle cerebral artery area

Objective: To explore the clinical value of imaging infarction mode in determination of the responsible vessel and mechanism of atherosclerotic middle cerebral artery area infarction. Methods: The ischemic stroke patients (105 cases) in department of neurology were continuously reviewed from January 2015 to December 2016, among which 68 cases were ICA infarction group and other 37 cases were MCA infarction group. The clinical data and vessel stenosis degree were compared, and then the cerebral infarction modes of ICA and MCA groups in different stenosis degree were analyzed. Results: The level of low density lipoprotein in ICA group was higher than that in MCA group, and the difference was statistically significant [ (2.34±0.70) mmol/L vs. (2.08±0.49) mmol/L, t=2.00, P<0.05]. There was no significant difference between the two groups in clinical history, collateral circulation, single and bilateral infarction, single and multiple infarction, and three triacylglycerol, high-density lipoprotein, and homocysteine. Totally 108 vessels were involved in 105 cerebral infarction patients, and 37 vessels of them were caused by MCA lesions, and other 71 vessels were caused by ICA lesions. The composition of mild stenosis arteries in ICA and MCA groups had statistically significant difference (42.3% vs. 8.1%, P<0.05) , and the composition of moderate stenosis, severe stenosis and occlusion vessel had no significant differences between two groups. The infarction modes of MCA and ICA groups including large area infarction (1/0 cases) , scattered cortical infarction (2/2 cases) , internal watershed infarction (3/13 cases) , external watershed infarction (7/9 cases) , single perforating artery infarction (7/13 cases) , mixed scattered cortex and internal water infarction (4/16 cases) , mixed perforating artery and internal water infarction (4/8 cases) , mixed internal watershed, perforating artery and scattered cortex infarction (9/10 cases) . The infarction modes of light, moderate and severe stenosis vessels in ICA and MCA groups have no statistical differences. The perforating artery infarct occurred higher in MCA occlusion group than that in ICA group (4/13 vs. 0/16, P=0.03) . Conclusions: The value of imaging infarction mode in clinical diagnosis of responsible vessels depends on a more rigorous study design, and the method using stenosis degree as grouping indicator may greatly influencd the study outcome. Key words: Internal carotid artery; Middle cerebral artery; Infarction model