Basal ganglionic infarction

Case contributed by Dr Ahmed Abdrabou

Presentation

Disturbed conscious level of 20 hours duration.

Patient Data

Age: 50 years
Gender: Female
MRI

Acute infarction involving the putamen, head and body of caudate nucleus as well as the posterior limb of internal capsule (territory of lateral lenticulostriate artery). It displays bright signal in DWI and low signal in ADC confirming the diffusion restriction status. Together with faintly bright signal in T2 and FLAIR without significant mass effect or  hemorrhage. MRA reveals complete occlusion of the right ICA with refilling of the ACA and MCA through circle of Willis.

Case Discussion

The basal ganglia receive their blood supply from the medial and lateral lenticulostriate arteries. While the former is a branch from the ACA that supplies the anteromedial head of caudate and anterior limb of the internal capsule, the latter is a branch from the MCA and supplies the putamen, head of caudate and posterior limb of the internal capsule. The thalamus, instead, receives its blood supply from the thalmoperforators arising from the posterior cerebral arteries. This patient is known to have SLE.

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Case information

rID: 28413
Published: 24th Mar 2014
Last edited: 19th Feb 2020
Inclusion in quiz mode: Included

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