Dynamics of regional distribution of ischemic lesions in middle cerebral artery trunk occlusion relates to collateral circulation

J Cereb Blood Flow Metab. 2011 Jan;31(1):36-40. doi: 10.1038/jcbfm.2010.185. Epub 2010 Oct 13.


We describe the regional distribution of acute perfusion, diffusion, and final infarct lesions in middle cerebral artery (MCA) trunk occlusion. A total of 31 patients with acute ischemic stroke and MCA trunk occlusion were studied by multiparametric magnetic resonance imaging. Probabilistic maps of lesion distribution were generated. The probability of initial and final infarcts was highest in the central MCA region with decreasing probability toward the periphery where the probability of the tissue at risk of infarction to be saved was highest. The probability of brain regions being involved in acute diffusion lesions and evolving into or escaping from the final infarct relates to the anatomy of arterial blood supply.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain / pathology
  • Brain Ischemia / pathology*
  • Brain Ischemia / physiopathology
  • Brain Mapping
  • Collateral Circulation / physiology*
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Image Processing, Computer-Assisted
  • Infarction, Middle Cerebral Artery / pathology*
  • Infarction, Middle Cerebral Artery / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Models, Statistical
  • Prospective Studies
  • Retrospective Studies
  • Stroke / drug therapy
  • Stroke / etiology
  • Stroke / physiopathology
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator / therapeutic use


  • Fibrinolytic Agents
  • Tissue Plasminogen Activator