Presentation
A known hypertensive with confusional state and left hemiplegia of two days duration
Patient Data
There is an ill-defined area of hypoattenuation involving the head and body of the right caudate nucleus, lentiform nucleus as well as the anterior and posterior limbs of the internal capsule. Near complete obliteration of the adjacent anterior horn of the lateral ventricle seen consistent with edema. The rest of the cerebrum and ventricular systems are preserved.
Features are those of an acute right basal ganglionic infarction
Case Discussion
The basal ganglia derive their blood supply from the lenticulostriate arteries. A portion of the anterior limb of the internal capsule and the head of caudate nucleus are supplied by the medial lenticulostriate arteries which are branches of the A1 segment of the anterior cerebral artery (ACA). The lateral lenticulostriate arteries which are branches from the M1 segment of the middle cerebral artery (MCA) supply the lentiform nucleus, parts of the caudate nucleus and the posterior limb of the internal capsule. The infarction described in this case represents regions supplied by both arteries.