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Middle cerebral artery syndrome is a condition whereby the blood supply from the middle cerebral artery (MCA) is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel: the lateral aspects of frontal, temporal and parietal lobes, the corona radiata, globus pallidus, caudate and putamen.
The middle cerebral artery (MCA) is one of the three major paired cerebral arteries that supply blood to the cerebrum. The MCA arises from the internal carotid artery and continues into the lateral sulcus where it then branches and projects to many parts of the lateral cerebral cortex .
Cerebral infarction, also known as an ischemic stroke, is the pathologic process that results in an area of necrotic tissue in the brain (cerebral infarct). [1] In mid to high income countries, a stroke is the main reason for disability among people and the 2nd cause of death. [ 2 ]
Mechanical removal of the blood clot causing the ischemic stroke, called mechanical thrombectomy, is a potential treatment for occlusion of a large artery, such as the middle cerebral artery. In 2015, one review demonstrated the safety and efficacy of this procedure if performed within 12 hours of the onset of symptoms.
The dense MCA sign is a dense artery sign observed on non-contrast computed tomography (CT) of the brain and is an important early marker of acute ischemic stroke involving the middle cerebral artery territory. [1] It refers to an abnormally increased attenuation (hyperdensity) of the MCA, reflecting an intraluminal thrombus or embolus.
Middle cerebral artery angiography, showing stenosis. During an ischaemic stroke, blood flow through a cerebral artery is compromised. This frequently causes substantial injury to the area of the brain supplied by the artery, but not all of this territory is necessarily affected.
(A) CT scan of a patient with middle cerebral artery stroke illustrating hypodensity areas within the temporal and frontal lobes. (B) CT scan displaying an ischemic stroke bordering the fronto-parietal opercular cortex (red arrow) and a left-sided ichemic lesion of the fronto-parietal opercular cortex (blue arrow).
A watershed stroke is defined as a brain ischemia that is localized to the vulnerable border zones between the tissues supplied by the anterior, posterior and middle cerebral arteries. [ 1 ] The actual blood stream blockage/restriction site can be located far away from the infarcts.