Lateral lenticulostriate infarction

Case contributed by Dr Oyedepo Victor Olufemi

Presentation

Known hypertensive with sudden onset left hemiplegia of a day duration

Patient Data

Age: 60 years
Gender: Male

There is a fairly marginated T2/FLAIR hyperintensity in the right cerebral hemispheres involving the lentiform nucleus, body of the caudate nucleus, and posterior limb of the internal capsule. T1W sequence shows subtle hypointensity, there is restricted diffusion on DWI/ ADC, no evidence of blooming on GRE to suggest bleed. The adjacent cerebral tissues are normal. No significant mass effect is seen.

Overall features are those of acute right lateral lenticulostriate infarction.

 

Case Discussion

The basal ganglia receive blood supply from the lenticulostriate arteries: the medial and lateral lenticulostriate arteries.

The medial lenticulostriate arteries are branches of the A1 segment of the anterior cerebral artery (ACA).   They supply the anterior limb of internal capsule, the head of the caudate nucleus, the globus pallidus, and the medial portion of the putamen. 

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 internal capsule.

 The infarction described in this case represents regions supplied by the lateral lenticulostriate arteries.

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