Abstract
We tested the hypothesis that frequency analysis of the anatomic zones affected by single anterior (A), posterior (P), and middle (M) cerebral artery (CA), multivessel, and watershed infarcts will disclose specific sites (peak zones) most frequently involved by each type, sites most frequently injured by multiple different types (vulnerable zones), and overlapping sites of equal relative frequency for two or more different types of infarct (equal frequency zones). We adopted precise definitions of each vascular territory. CT and MRI studies of 50 MCA, 20 ACA-MCA, three PCA-MCA, and 30 parasagittal watershed infarcts were mapped onto a standard template. Relative infarct frequencies in each zone were analyzed within and across infarct types to identify the centers and peripheries of each, vulnerable zones, and equal frequency zones. These data were then correlated with the prior analysis of 47 ACA, PCA, dual ACA-PCA, and ACA-PCA-MCA infarcts. Zonal frequency data for MCA and watershed infarcts, the sites of peak infarct frequency, the sites of vulnerability to diverse infarcts, and the overlapping sites of equal infarct frequency are tabulated and displayed in standardized format for direct comparison of different infarcts. This method successfully displays the nature, sites, and extent of individual infarct types, illustrates the shifts in zonal frequency and lesion center that attend dual and triple infarcts, and clarifies the relationships among the diverse types of infarct.
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Naidich TP, Brightbill TC (2003) Vascular territories and watersheds: a zonal frequency analysis of the gyral and sulcal extent of cerebral infarcts. Part I: the anatomic template. Neuroradiology (in press)
Naidich TP, Firestone MI, Blum JT, Abrams KJ, Zimmerman RD (2003) Vascular territories and watersheds: a zonal frequency analysis of the gyral and sulcal extent of cerebral infarcts. Part II: Anterior and posterior cerebral artery infarcts. Neuroradiology (in press)
Perlmutter D, Rhoton AL Jr (1978) Microsurgical anatomy of the distal anterior cerebral artery. J Neurosurg 49: 204–228
Gloger S, Gloger A, Vogt H, Kretschmann HJ (1994) Computer-assisted 3D reconstruction of the terminal branches of the cerebral arteries. I. Anterior cerebral artery. Neuroradiology 36: 173–180
Gloger S, Gloger A, Vogt H, Kretschmann HJ (1994) Computer-assisted 3D reconstruction of the terminal branches of the cerebral arteries. II. Middle cerebral artery. Neuroradiology 36: 181–187
Gloger S, Gloger A, Vogt H, Kretschmann HJ (1994) Computer-assisted 3D reconstruction of the terminal branches of the cerebral arteries. III. Posterior cerebral artery and circle of Willis. Neuroradiology 36: 251–257
Bogousslavsky J, Regli F (1986) Unilateral watershed cerebral infarcts. Neurology 36: 373–377
Bogousslavsky J, Regli F (1990) Anterior cerebral artery territory infarction in the Lausanne Stroke Registry. Arch Neurol 47: 144–150
Kazui S, Sawada T, Hiroaki N, Yoshihiro K, Yamaguchi T (1993) Angiographic evaluation of brain infarction limited to the anterior cerebral artery territory. Stroke 24: 549–553
Krapf H, Widder B, Skalej M (1998) Small rosary-like infarctions in the centrum ovale suggest hemodynamic failure. AJNR 19: 1479–1484
Yamauchi H, Fukuyama H, Yamaguchi S, Miyoshi T, Kimura J, Konishi J (1991) High-intensity area in the deep white matter indicating hemodynamic compromise in internal carotid artery occlusive disorders. Arch Neurol 48: 1067–1071
Naidich TP, Blum JT, Firestone MI (2001) The parasagittal line: an anatomic landmark for axial imaging. AJNR 22: 885–895
Naidich TP, Brightbill TC (1996) The pars marginalis: Part I. A “bracket” sign for the central sulcus in axial plane CT and MRI. Int J Neuroradiol 2: 3–19
Naidich TP, Brightbill TC (1996) The pars marginalis: Part II. The pars deflection sign: a white matter pattern for identifying the pars marginalis in axial plane CT and MRI. Int J Neuroradiol 2: 20–24
Naidich TP, Brightbill TC (1996) Systems for localizing fronto-parietal gyri and sulci on Axial CT and MRI. Int J Neuroradiol 2: 313–338
Valente M, Naidich TP, Abrams KJ, Blum JT (1998) Differentiating the pars marginalis from the parieto-occipital sulcus in axial computed tomography sections. Int J Neuroradiol 4: 105–111
Zwan A van der, Hillen B (1991) Review of the variability of the territories of the major cerebral arteries. Stroke 22: 1078–1084
Zwan A van der, Hillen B, Tulleken CAF, Dujovny M, Dragovic L (1992) Variability of the territories of the major cerebral arteries. J Neurosurg 77: 927–940
Zwan A van der, Hillen B, Tulleken CAF, Dujovny MA (1993) Quantitative investigation of the variability of the major cerebral arterial territories. Stroke 24: 1951–1959
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Naidich, T.P., Firestone, M.I., Blum, J.T. et al. Zonal frequency analysis of the gyral and sulcal extent of cerebral infarcts. Part III: Middle cerebral artery and watershed infarcts. Neuroradiology 45, 785–792 (2003). https://doi.org/10.1007/s00234-003-1017-x
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DOI: https://doi.org/10.1007/s00234-003-1017-x