Anterior cerebral artery (ACA) infarct
Citation, DOI, disclosures and article data
At the time the article was created Henry Knipe had no recorded disclosures.View Henry Knipe's current disclosures
At the time the article was last revised Craig Hacking had no recorded disclosures.View Craig Hacking's current disclosures
Anterior cerebral artery (ACA) territory infarcts are much less common than either middle or posterior cerebral artery territory infarcts.
On this page:
ACA territory infarcts are rare, comprising ~2% of ischemic strokes 1,2.
ACA stroke syndrome presents as 1-3:
- dysarthria, aphasia
- unilateral contralateral motor weakness (leg/shoulder > arm/hand/face)
- minimal sensory changes (two-point discrimination) in the same distribution as above
- left limb apraxia
- urinary incontinence
ACA territory infarcts are less common because if the A1 segment is occluded there is generally enough collateral flow via the contralateral A1 segment to supply the distal ACA territory 2.
Embolic strokes (often with MCA involvement) are the most common cause 3. Rarely, they are also seen as a complication of severe midline shift, where the ACA is occluded by mass effect or severe vasospasm.
The features are those of cerebral infarction in the anterior cerebral artery vascular territory:
- paramedian frontoparietal cerebral cortex
- anterior corpus callosum
- anterior limb of the internal capsule
- inferior portion of the caudate head
- 1. Stein J, Harvey RL, Macko RF et-al. Stroke Recovery and Rehabilitation. Demos Medical. ISBN:1933864125. Read it at Google Books - Find it at Amazon
- 2. Stroke syndromes. Cambridge University Press. ISBN:052180258X. Read it at Google Books - Find it at Amazon
- 3. Arboix A, García-Eroles L, Sellarés N et-al. Infarction in the territory of the anterior cerebral artery: clinical study of 51 patients. BMC Neurol. 2009;9 (1): 30. doi:10.1186/1471-2377-9-30 - Free text at pubmed - Pubmed citation