The internal capsule and basal nuclei are supplied by perforating branches of the anterior cerebral artery (ACA), Heubner's artery, middle cerebral artery (MCA), internal carotid artery (ICA) and anterior choroidal artery (AChA). Some of the mentioned perforators vascularize both the internal capsule and basal nuclei, while some of them also perfuse the adjacent brain structures. Dorsal part of the anterior limb, knee and posterior limb of the internal capsule are commonly supplied by lateral MCA perforators. The intermediate part of the anterior limb is perfused by medial MCA perforators, while its ventral part is nourished by ACA perforators and Heubner's artery. The intermediate part of the knee is supplied by medial MCA perforators, while its ventral part is mostly vascularized by ICA and proximal AChA perforators. The intermediate part of the posterior limb is perfused by medial MCA perforators anteriorly and the proximal AChA perforators posteriorly. The ventral part is supplied by AChA perforators. The retrolenticular and sublenticular portions of the internal capsule are mainly nourished by distal AChA perforators. The caudate nucleus is supplied by perforators of the ACA, MCA and AChA, as well as by branches of the lateral posterior choroidal artery. Most of the putamen is vascularized by MCA perforators, and smaller parts by ACA and AChA perforators. The lateral segment of the globus pallidus is perfused by MCA perforators and partially by Heubner's artery and ACA, while its medial segment is supplied by ICA and AChA perforators. The ACA perforators, that most often originate from the initial 5.9 mm of the A1 segment, range in number from 1 to 5 (mean, 2.2) and in diameter between 80 pm and 710 pm (average, 295 microm). Heubner's artery, which most often arises close to the anterior communicating artery, can be singular (72.5%), double (23%) or triple (4.5%). It varies in diameter from 190 microm to 1,600 pm (average, 750 microm) and in length between 11 mm and 36 mm (mean, 22.4 mm). The MCA perforators, that most frequently originate from M1 segment (90.7%) and leptomeningeal branches (62.6%), range in number between 2 and 13 (mean, 8.1) and in diameter from 80 microm to 1,300 microm (mean, 520 microm). Many perforators arise as individual vessels, and some of them with common trunks (70.8%). Medial and lateral group of these perforators can be distinguished. The ICA perforators, which more often arise close to the AChA originating site (35.4%) than from the ICA bifurcation point (10.4%), vary in number from 1 to 5 (average, 3) and in diameter between 70 microm and 500 microm (mean, 236 microm). The AChA perforators that originate from its cisternal segment, range in number from 2 to 9 (mean, 4.5) and in diameter from 90 microm to 600 pm (mean, 325 microm).
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http://dx.doi.org/10.2298/sarh0502041v | DOI Listing |
Quant Imaging Med Surg
December 2024
Department of Neurointervention, the First Affiliated Hospital of Zhengzhou University, Henan Provincial Neurointerventional Engineering Research Center, Zhengzhou, China.
Background: Patterns of arterial remodeling may be associated with outcomes in patients with severe middle cerebral artery (MCA) stenosis after endovascular treatment (EVT). This study aims to investigate the potential correlation between arterial remodeling patterns in patients with severe MCA stenosis, and plaque characteristics and procedure-related perforator stroke (PS).
Methods: Consecutive patients with MCA atherosclerotic disease who underwent EVT at the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2023 were retrospectively enrolled in this study.
Surg Radiol Anat
November 2024
Neuroradiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, Reggio Emilia, 42123, Italy.
Purpose: Middle cerebral artery (MCA) anomalies are a small group of congenital variants, including fenestration, duplication and Twig-like MCA. Some other variants, i.e.
View Article and Find Full Text PDFInterv Neuroradiol
October 2024
Department of Neurology, University of Chicago, Chicago, IL, USA.
Background: Acute ischemic stroke (AIS) due to intracranial atherosclerotic disease (ICAD) carries a high risk of recurrence despite aggressive medical management. The aim of our study is to present our initial experience with the Onyx Frontier™ balloon-mounted drug-eluting stent (Medtronic, Santa Rosa, CA) for AIS due to ICAD.
Methods: We conducted a multicenter retrospective cohort study describing the technical feasibility, safety, and performance of using the Onyx Frontier™ balloon-mounted drug-eluting stent in patients with acute intracranial vessel occlusion due to ICAD across three comprehensive stroke centers in the United States.
Neurol India
September 2024
The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China.
Management of giant complex thrombosed aneurysms of the middle cerebral artery (MCA) is challenging. Most giant MCA aneurysms possess some unfavorable features, such as incorporation of key MCA branches, efferent or perforating vessels originating from the sac, mural calcifications, intraluminal thrombi, or fusiform configurations. Due to these peculiar features, traditional clipping or simple endovascular coiling is generally not able to treat these aneurysms.
View Article and Find Full Text PDFNeurosurg Rev
September 2024
Department of Neurosurgery, Istinye University, Istanbul, Turkey.
Background And Objectives: The internal capsule is supplied by perforators originating from the internal carotid artery, middle cerebral artery, anterior choroidal artery and anterior cerebral artery. The aim of this study is to examine the vascular anatomy of the internal capsule, along with its related white matter anatomy, in order to prevent potential risks and complications during surgical interventions.
Methods: Twenty injected hemispheres prepared according to the Klingler method were dissected.
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