Anterior cerebral artery (ACA) infarct
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Anterior cerebral artery territory(ACA) infarct
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Anterior cerebral artery (ACA) territory infarcts are much less common than either middle or posterior cerebral artery territory infarcts.
Epidemiology
ACA territory infarcts are rare, comprising ~2% of ischaemic strokes strokes 1,2.
Clinical presentation
ACA stroke syndrome presents as 1,2,3:
- dysarthria, aphasia
- unilateral contralateral
motormotor weakness(leg/shoulder > arm/hand/face) - minimal sensory changes (two-point discrimination) in the same distribution as above
- left limb apraxia
- urinary incontinence
Pathology
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 territory2.
Embolic strokes (often with MCA involvement) are the most common cause 3. Rarely, they are also seen as a complication of severemidline shift, where the ACA is occluded by mass effect, or severe vasospasm.
Radiographic features
Generally the features are those of cerebral infarction but in the anterior cerebral artery vascular territory of the paramedian frontal parietal cerebral cerebral cortex, anterior corpus callosum and internal capsule, and inferior caudate head. As such these features are discussed in generic article: cerebral infarction.
Differential diagnosis
-<p><strong>Anterior cerebral artery (ACA) territory infarcts</strong> are much less common than either <a href="/articles/middle-cerebral-artery-infarction">middle</a> or <a href="/articles/posterior-cerebral-artery-pca-infarction">posterior cerebral artery territory infarcts</a>. </p><h4>Epidemiology</h4><p><a href="/articles/anterior-cerebral-artery">ACA</a> territory infarcts are rare, comprising ~2% of ischaemic strokes <sup>1,2</sup>. </p><h4>Clinical presentation</h4><p>ACA stroke syndrome presents as <sup>1,2,3</sup>:</p><ul>- +<p><strong>Anterior cerebral artery (ACA) territory infarcts</strong> are much less common than either <a href="/articles/middle-cerebral-artery-mca-infarction-2">middle</a> or <a href="/articles/posterior-cerebral-artery-pca-infarction">posterior cerebral artery territory infarcts</a>. </p><h4>Epidemiology</h4><p><a href="/articles/anterior-cerebral-artery">ACA</a> territory infarcts are rare, comprising ~2% of ischaemic strokes <sup>1,2</sup>. </p><h4>Clinical presentation</h4><p>ACA stroke syndrome presents as <sup>1,2,3</sup>:</p><ul>
-<li>unilateral contralateral motor weakness (leg/shoulder > arm/hand/face)</li>- +<li>unilateral contralateral motor weakness (leg/shoulder > arm/hand/face)</li>
-</ul><h4>Pathology</h4><p>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 <sup>2</sup>. </p><p>Embolic strokes (often with MCA involvement) are the most common cause <sup>3</sup>. Rarely, they are also seen as a complication of severe <a href="/articles/midline-shift">midline shift</a>, where the ACA is occluded by mass effect, or severe <a href="/articles/cerebral-vasospasm-following-sah">vasospasm</a>.</p><h4>Radiographic features</h4><p>Generally the features are those of cerebral infarction but in the anterior cerebral artery <a href="/articles/cerebral-vascular-territories">vascular territory</a> 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: <a href="/articles/stroke">cerebral infarction</a>.</p><h4>Differential diagnosis</h4><ul>- +</ul><h4>Pathology</h4><p>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 <sup>2</sup>. </p><p>Embolic strokes (often with MCA involvement) are the most common cause <sup>3</sup>. Rarely, they are also seen as a complication of severe <a href="/articles/midline-shift">midline shift</a>, where the ACA is occluded by mass effect, or severe <a href="/articles/cerebral-vasospasm-following-subarachnoid-haemorrhage">vasospasm</a>.</p><h4>Radiographic features</h4><p>Generally the features are those of cerebral infarction but in the anterior cerebral artery <a href="/articles/cerebral-vascular-territories">vascular territory</a> 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: <a href="/articles/stroke">cerebral infarction</a>.</p><h4>Differential diagnosis</h4><ul>
-<li><a href="/articles/cerebral-venous-infarction">cerebral venous infarct</a></li>- +<li><a href="/articles/cerebral-venous-infarction">cerebral venous infarct</a></li>
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