Magnetic Resonance Angiographic Findings and Clinical Outcome of the Striatocapsular Infarction

BACKGROUND: Striatocapsular infarction involves the territory of the large lateral striate branches of the middle cerebral artery sparing the overlying cortex. Two kinds of angiographic findings of the striatocapsular infarction have been reported previously: one with a complete occlusion of the M1 segment and the other without. However, the clinical features and outcomes in relation to the magnetic resonance angiographic (MRA) findings remain unknown. In the present study, we evaluated the clinical outcomes in patients with striatocapsular infarctions according to the MRA findings. METHODS: Twenty-two consecutive patients with striatocapsular infarctions who were admitted to the Chosun University Hospital between July 1998 and June 2000 were included in the study. Striatocapsular infarction was confirmed by magnetic resonance imaging (MRI) and MRA. The patients were divided into two groups based on MRA findings. Ten patients with occluded MCA were included in group A, and the remaining 12 patients with normal or stenotic MCA were categorized as group B. We compared their clinical characteristics and outcomes at 3-months post-stroke. RESULTS: Only 1 out of 12 patients in group B and 6 out of 10 patients in group A showed cortical symptoms and signs. Patients in group A tended to have more severe disability and a worse prognosis than those in group B. CONCLUSIONS: The MRA findings may help clinicians to better predict the clinical outcomes after striatocapsular infarctions. (J Korean Neurol Assoc 19(5):452~456, 2001)

Two Cases of Primary Progressive Aphasia

Primary progressive aphasia (PPA) is an uncommon neurodegenerative syndrome characterized by a progressive deterioration of language, while nonverbal cognitive and other neurological functions of PPA are relatively preserved for a longer period. However, it still remains unclear whether PPA represents a distinct diagnostic entity or a precursor of global dementia syndrome. We report PPA cases that presented with a slowly progressive language dysfunction without disturbing other daily living activities for several years. Repeated neuropsychological tests revealed progres-sive deterioration of executive aspects of language and mild memory dysfunction, although their receptive language and nonverbal cognitive functions were relatively preserved. The imaging of the brain showed prominent atrophic changes in the left perisylvian and the adjacent temporal region. In considering the mild cognitive decline accompanied by language deterioration, we conclude that in these cases it is clinically heterogenous and may be parts of a spectrum of focal forms of non-Alzeimer type dementia.