Middle cerebral artery stenosis is a major clinical determinant in striatocapsular small, deep infarction.

Abstract

SEVERAL THEORIES explain the pathogenesis of symptomatic small, deep infarctions. Small-vessel disease resulting from hypertension is generally thought to be the most common cause and to have characteristic clinical features and a good prognosis. Extracranial sources of emboli, such as cardiac problems or the atherosclerosis of the internal carotid artery, have been found in patients with small, deep infarctions.^1,2 Atherosclerosis of the middle cerebral artery (MCA) may also occlude the origin of deep perforators resulting in striatocapsular small, deep infarctions (SSDIs).^3-5 However, the frequency of the MCA occlusive lesions, ranging from 2%¹ to 21%,⁶ in patients with SSDIs has rarely been described. Previous studies have shown that atherosclerotic involvement of the intracranial vessels occur more frequently in Asian patients than in Westerners.^3,5 Therefore, the frequency of the MCA occlusive lesions with SSDIs may be more prevalent in Asian patients. However, to our knowledge, this has not yet been reported.