J Korean Geriatr Soc.  2004 Dec;8(4):252-255.

Posterior Circulation Infarction Leading to Malignant MCA Infarction

• Park JH

Abstract

Malignant MCA(middle cerebral artery) infarction is one of the leading cause of fatal stroke. It is usually caused by occlusion of the ipsilateral MCA or ICA(internal carotid artery). We report a 62-year-old man with posterior circulation stroke(distal basilar artery occlusion) which was later developed in malignant MCA infarction. MRI(magnetic resonance imaging) revealed high signal intensities in more than 2/3 of the right hemispheres and also in the bilateral thalamus, occipital cortices extending to the midbrain, pons and right SCA(superior cerebellar artery) territory of the cerebellum. Ipsilateral ICA and MCA of the infarcted hemisphere were not visible but ipsilateral PCA(posterior cerebral artery) seemed to be relatively prominent compared with the contralateral side in MR Angiography. From the pont of view of the initial pathologic brainstem sign and MR findings, we suggest that embolic occlusion of the distal basilar artery might be responsible for malignant right MCA infarction in this patient, from which the right PCA had dominantly supplied the most of the ipsilateral hemisphere.

MeSH Terms

Angiography
Basilar Artery
Brain Stem
Cerebellum
Humans
Infarction*
Infarction, Middle Cerebral Artery*
Mesencephalon
Middle Aged
Passive Cutaneous Anaphylaxis
Pons
Stroke
Thalamus