True or false: The pathology is located in the vascular territory of the lateral lenticulostriate arteries.
False. The abnormality is located in the vascular territory of the largest medial lenticulostriate artery a.k.a. recurrent artery of Heubner (RHA).
Name possible symptoms of the above mentioned finding.
Isolated infarction of the territory of this vessel as seen in this case may either be clinically silent or give rise to contralateral hemiparesis most prominent in the face and upper extremity.
CT study of the head reveals no acute abnormalities.
There is loss of substance in the right-sided head of the caudate, anterior putamen and anterior limb of the internal capsule with slight secondary dilatation of the right lateral ventricle and frontal horn, consistent with infarction in the territory of right recurrent artery of Heubner (RHA).
There is intracranial atherosclerosis of the intraclinoid segment of both internal carotid arteries (ICA).
No further evidence of atherosclerotic disease, no evidence of former surgery.
Bones, paranasal sinuses and mastoid are unremarkable except slight polypoid mucosal thickening in anterior wall of left maxillary sinus.
Conclusion
No acute intracranial abnormality.
Chronic changes comprising lacunar infarction of right recurrent Heubner artery territory and intracranial atherosclerosis of both ICAs - correlation with patient history, inherited disposition and various blood test including lipid profile recommended.