middle cerebral artery syndrome (M1 stenosis)
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Etiology
- occlusion of the middle cerebral artery
Epidemiology
- most common site for ischemic stroke
Pathology
- may affect lateral aspects of frontal lobe, temporal lobe & parietal lobe
- corona radiata, globus pallidus, caudate & putamen may be affeced
- cerebral edema, increased intracranial pressure, loss of consciousness & death with severe, proximal obstruction
Clinical manifestations
- hemiparesis or hemiplegia
- lower half of the contralateral face
- contralateral upper & lower extremities
- sensory loss of the contralateral face, arm and leg
- taxia of contralateral extremities*
- speech impairment/aphasia:
- Broca's aphasia, Wernicke's aphasia or Global aphasia as a result of a dominant hemisphere lesion (usually left brain)
- perceptual deficits as a result of a non-dominant hemisphere lesion (usually right brain)
- hemispatial neglect
- anosognosia
- apraxia
- spatial disorganization
- visual disorders:
- gaze preference towards the side of the lesion
- contralateral homonymous hemianopsia
Laboratory
- see ischemic stroke
Radiology
- see ischemic stroke
Management
- stenting of intracranial artery stenosis is not recommended
- higher risk of stroke of death vs medical therapy[3]
- see ischemic stroke
More general terms
Additional terms
References
- ↑ Wikipedia: Middle cerebral artery syndrome http://en.wikipedia.org/wiki/Middle_cerebral_artery_syndrome
- ↑ Slater D and Campagnolo D Medscape (eMedicine): Middle Cerebral Artery Stroke http://emedicine.medscape.com/article/323120-overview
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
Luo J, Wang T, Yang K et al. Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis. Cochrane Database Syst Rev. 2023;2:CD013267. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36738471