전뇌동맥 영역의 뇌경색;원인 및 임상증상과 방사선과적 소견의 상관관계에 대한 연구

Abstract

Backgrounds & Objectives : Anterior cerebral artery(ACA)territory infarction is uncommon and its etiology has not been fully investigated. The aim of this study was to verify its pathophysiologic mechanisms and to make clinicoradiological correlations. Methods : We studied 42 patients who had brain image findings compatible with ACA infarction. We analyzed the clinical features, and CT/MRI and angiography findings. Results : Among the etiologies, atherosclerosis was the most common (74%), while cardiac embolism was the cause in only 2 patients(5%). Most frequently involved anatomic structures were the corpus callosum(rostrum, genu) and the superior frontal area, whereas whole ACA territory was rarely involved (1 patient). Clinical features were:hemiparesis (69%: arm > leg, 10%; arm=leg, 52%; arm < leg, 38%), sensory deficit(17%), leg monoparesis(14%),apathy(52%), urinary incontinence(33%),language disorder(12%), alien hand syndrome(7%), memory disturbance(10%), and callosal disconnection syndrome(2%). Symptoms such as motor weakness, abulia, urinary incontinence, and callosal disconnection syndrome correlated well with the location of the infarcted area. Angiography performed in 38 patients showed ACA disease in 31 patients(stenosis/occlusion at A1 in 31%, at A2 in 21%, and at pericallosal artery in 5%). Stenoocculsive site of ACA did not predict the extent of infarction. Conclusion : The pathogenesis of ACA infarction is related mostly to atherosclerosis. The clinical symptoms were related to the location of the lesion. Poor correlation between the lesion size and the location of vascular occlusion may be explained by the variable collateral circulation. Korean Journal of Stroke 2001;3(1): 47~59