Anatomical distribution and clinical significance of middle cerebral artery M2 segment vessel occlusions and its cortical branches in acute ischaemic stroke patients

Background Characterisation of anatomical distribution and the clinical impact of middle cerebral artery M2 (MCA-M2) segment occlusion and its subsequent cortical branches (CBs) in acute ischaemic stroke patients (AIS).Methods Retrospective, monocentric study analysing radiological and clinical data...

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Main Authors: Philipp Gruber, Jatta Berberat, Javier Anon, Luca Remonda, Lukas Andereggen, Paola Valbuena, Renske Sassenburg
Format: Article
Language:English
Published: BMJ Publishing Group 2023-10-01
Series:BMJ Neurology Open
Online Access:https://neurologyopen.bmj.com/content/5/2/e000450.full
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author Philipp Gruber
Jatta Berberat
Javier Anon
Luca Remonda
Lukas Andereggen
Paola Valbuena
Renske Sassenburg
author_facet Philipp Gruber
Jatta Berberat
Javier Anon
Luca Remonda
Lukas Andereggen
Paola Valbuena
Renske Sassenburg
author_sort Philipp Gruber
collection DOAJ
description Background Characterisation of anatomical distribution and the clinical impact of middle cerebral artery M2 (MCA-M2) segment occlusion and its subsequent cortical branches (CBs) in acute ischaemic stroke patients (AIS).Methods Retrospective, monocentric study analysing radiological and clinical data of AIS patients with MCA-M2 segment occlusion with regard to the anatomic distribution of MCA-M2 occlusion and its subsequent CB.Results A total of 203 patients (median age 77 (IQR 66–83) years, 112 women) were included. There was an equal distribution of right-sided versus left-sided MCA-M2 vessel occlusions (right: n=97; left: n=106), as well as with a median number of affected MCA-M2 CBs of 4 (IQR, 3–6) and a median National Institute of Health Stroke Scale score (NIHSS) on admission of 9 (3–15). For both hemispheres, CBs of the inferior trunks were significantly more affected than the superior trunks. Endovascular treatment (EVT, n=94) was associated with a significant better outcome compared with patients with medical management alone (p=0.027).Conclusion In acute MCA-M2 segment occlusions, inferior trunks are significantly more affected compared with the superior trunks. The subsequent CBs of the paracentral region of both hemispheres are more commonly involved. In eloquent vascular territories, EVT was more often performed.
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spelling doaj-art-9e4c97bdc3be4c18971f1cc1947a8ada2025-08-20T02:00:56ZengBMJ Publishing GroupBMJ Neurology Open2632-61402023-10-015210.1136/bmjno-2023-000450Anatomical distribution and clinical significance of middle cerebral artery M2 segment vessel occlusions and its cortical branches in acute ischaemic stroke patientsPhilipp Gruber0Jatta Berberat1Javier Anon2Luca Remonda3Lukas Andereggen4Paola Valbuena5Renske Sassenburg6Department of Neuroradiology, Kantonsspital Aarau AG, Aarau, SwitzerlandDepartment of Neuroradiology, Kantonsspital Aarau AG, Aarau, SwitzerlandDepartment of Neuroradiology, Kantonsspital Aarau AG, Aarau, SwitzerlandDepartment of Neuroradiology, Kantonsspital Aarau AG, Aarau, SwitzerlandDepartment of Neurosurgery, Kantonsspital Aarau AG, Aarau, SwitzerlandDepartment of Neuroradiology, Kantonsspital Aarau AG, Aarau, SwitzerlandDepartment of Neuroradiology, Kantonsspital Aarau AG, Aarau, SwitzerlandBackground Characterisation of anatomical distribution and the clinical impact of middle cerebral artery M2 (MCA-M2) segment occlusion and its subsequent cortical branches (CBs) in acute ischaemic stroke patients (AIS).Methods Retrospective, monocentric study analysing radiological and clinical data of AIS patients with MCA-M2 segment occlusion with regard to the anatomic distribution of MCA-M2 occlusion and its subsequent CB.Results A total of 203 patients (median age 77 (IQR 66–83) years, 112 women) were included. There was an equal distribution of right-sided versus left-sided MCA-M2 vessel occlusions (right: n=97; left: n=106), as well as with a median number of affected MCA-M2 CBs of 4 (IQR, 3–6) and a median National Institute of Health Stroke Scale score (NIHSS) on admission of 9 (3–15). For both hemispheres, CBs of the inferior trunks were significantly more affected than the superior trunks. Endovascular treatment (EVT, n=94) was associated with a significant better outcome compared with patients with medical management alone (p=0.027).Conclusion In acute MCA-M2 segment occlusions, inferior trunks are significantly more affected compared with the superior trunks. The subsequent CBs of the paracentral region of both hemispheres are more commonly involved. In eloquent vascular territories, EVT was more often performed.https://neurologyopen.bmj.com/content/5/2/e000450.full
spellingShingle Philipp Gruber
Jatta Berberat
Javier Anon
Luca Remonda
Lukas Andereggen
Paola Valbuena
Renske Sassenburg
Anatomical distribution and clinical significance of middle cerebral artery M2 segment vessel occlusions and its cortical branches in acute ischaemic stroke patients
BMJ Neurology Open
title Anatomical distribution and clinical significance of middle cerebral artery M2 segment vessel occlusions and its cortical branches in acute ischaemic stroke patients
title_full Anatomical distribution and clinical significance of middle cerebral artery M2 segment vessel occlusions and its cortical branches in acute ischaemic stroke patients
title_fullStr Anatomical distribution and clinical significance of middle cerebral artery M2 segment vessel occlusions and its cortical branches in acute ischaemic stroke patients
title_full_unstemmed Anatomical distribution and clinical significance of middle cerebral artery M2 segment vessel occlusions and its cortical branches in acute ischaemic stroke patients
title_short Anatomical distribution and clinical significance of middle cerebral artery M2 segment vessel occlusions and its cortical branches in acute ischaemic stroke patients
title_sort anatomical distribution and clinical significance of middle cerebral artery m2 segment vessel occlusions and its cortical branches in acute ischaemic stroke patients
url https://neurologyopen.bmj.com/content/5/2/e000450.full
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