Abstract:

Objective   To study the clinical and neuroimaging features of patients with unilateral middle cerebral artery (MCA) stenosis and to investigate its mechanism. Methods   30 patients with unilateral MCA stenosis were screened by magnetic resonance angiography (MRA) and carotid ultrasound. Further examinations such as diffusionweighted imaging (DWI) and digital subtraction angiography (DSA)were performed and the relationship between the results and their clinical data was analysed. Results   Among the 30 patients, 23 had acute stroke, 5 had transient ischemic attack (TIA) and 2 were asymptomatic. Among the patients with acute stroke, 16 had multiple acute infarcts and 7 had single acute infarcts. Among the patients with TIA, 2 had multiple lacunars and the other 3 had no positive findings on DWI. 2 asymptomatic patients had no positive findings on DWI. Conclusion   Various stroke patterns may be present in the patients with MCA stenosis. The possible common stroke mechanism include artery-to-artery embolism, stem plaque strentching and hypopefusion resulting from stenosis. Individualized treatment should be formulated according to different pathogenesis.

Key words: Middle cerebral aetery; Stenosis; Ischemic stroke; Clinical features; Neuroimaging; Mechanism