Anterior cerebral artery (ACA) infarct

Dr Henry Knipe et al.

Anterior cerebral artery (ACA) territory infarcts are much less common than either middle or posterior cerebral artery territory infarcts

ACA territory infarcts are rare, comprising ~2% of ischaemic strokes 1,2

ACA stroke syndrome presents as 1,2,3:

  • 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.

Generally the features are those of cerebral infarction but in the anterior cerebral artery vascular territory of the paramedian frontal parietal cerebral cortex, anterior corpus callosum and internal capsule, and inferior caudate head. As such these features are discussed in generic article: cerebral infarction.

Stroke and intracranial haemorrhage
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Article information

rID: 39171
Section: Pathology
Synonyms or Alternate Spellings:
  • ACA infarct
  • Anterior cerebral artery infarct
  • Anterior cerebral artery (ACA) territory infarcts

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Cases and figures

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    Figure 1: ACA territory (yellow)
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    Figure 2: ACA territory (yellow)
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    Figure 3: vascular territories
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    Case 1: as complication of MCA infarct
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    Case 2: cardio-embolic
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    Case 3
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    Case 4
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