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Zonal frequency analysis of infarct extent. Part II: Anterior and posterior cerebral artery infarctions

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Abstract

The object of the study was to test the hypotheses that analysis of the anatomic zones affected by single anterior (A), posterior (P), and middle (M) cerebral artery (CA) infarcts, and by dual- and triple-vessel infarcts, will disclose (i) sites most frequently involved by each infarct type (peak sites), (ii) sites most frequently injured by multiple different infarct types (vulnerable zones), and (iii) anatomically overlapping sites in which the relative infarct frequency becomes equal for two or more different infarct types and/or in which infarct frequency shifts greatly between single and multivessel infarcts (potential border zones). Precise definitions of each vascular territory were adopted. CT and MRI studies from 20 ACA, 20 PCA, three dual ACA-PCA, and four triple ACA-PCA-MCA infarcts were mapped onto a standard template (Part I). Relative infarct frequencies in each zone were analyzed within and across infarct types to identify the centers and peripheries of each infarct type, the zones most frequently affected by multiple different infarct types, the zones where relative infarct frequency was equal for different infarcts, and the zones where infarct frequency shifted markedly from single- to multiple-vessel infarcts. Zonal frequency analysis provided quantitative data on the relative infarct frequency in each anatomic zone for each infarct type. It displayed zones of peak infarct frequency for each infarct, zones more vulnerable to diverse types of infarct, peripheral "overlap" zones of equal infarct frequency, and zones where infarct frequency shifted markedly between single- and multiple-vessel infarcts. It is concluded that the hypotheses are correct.

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Acknowledgements

The authors would like to thank Drs. Stanley Tuhrim and Paul Wright for their help with obtaining statistics on the diverse types of infarcts in other studies, and Sue Ann Fung-Ho, Medical Illustrator at the Rockefeller University, for preparing the beautiful illustrative diagrams.

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Authors and Affiliations

  1. Department of Radiology, The Mount Sinai Medical Center, One Gustave Levy Place, Box 1234, New York, NY 10029, USA

    Thomas P. Naidich & Michael I. Firestone

  2. 506 Ridgeview Drive, Clarks Summit, PA 18411, USA

    Jeffrey T. Blum

  3. Department of Radiology, Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL 33176, USA

    Kevin J. Abrams

  4. Department of Radiology, New York Hospital–Cornell, 525 East 68th Street, New York, NY 10021, USA

    Robert D. Zimmerman

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  1. Thomas P. Naidich
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  2. Michael I. Firestone
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Correspondence to Thomas P. Naidich.

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Naidich, T.P., Firestone, M.I., Blum, J.T. et al. Zonal frequency analysis of infarct extent. Part II: Anterior and posterior cerebral artery infarctions. Neuroradiology 45, 601–610 (2003). https://doi.org/10.1007/s00234-003-1016-y

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