Presentation
Acute onset right lower limb weakness.
Patient Data
Age: 50 years
Gender: Male
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- chronic lacunar infarctions in bilateral basal ganglia ( right > left).
- loss of grey white matter differentiation involving left frontal lobe interhemispheric parasagittal cortex.
- no extra axial or intra axial hemorrhage.
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- DW imaging confirms acute infarction - territorial to left ACA.
- Angiogram reveals a small caliber A2 and distal segments of left anterior cerebral artery.
Case Discussion
Anterior cerebral artery (ACA) territory infarctions are less common due to plush contralateral collateral flow through the anterior communicating and left middle cerebral artery.
Usually embolic strokes are responsible for acute ACA territory infarcts. The zonal delineation of the arterial territory is well depicted in this case.
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