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Tertiary microvascular territories define lacunar infarcts in the basal ganglia
Author(s) -
Feekes Joel A.,
Hsu ShihWei,
Chaloupka John C.,
Cassell Martin D.
Publication year - 2005
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.20505
Subject(s) - anatomy , basal ganglia , artery , basal (medicine) , cerebral arteries , medicine , anastomosis , pathology , central nervous system , radiology , cardiology , surgery , insulin
Lacunar infarcts are commonly found in the basal ganglia, though little is known about the organization of small‐scale microvascular territories that presumably subtend lacunae. We investigated microvascular territories of the lenticulostriate arteries, the recurrent artery of Heubner, the anterior choroidal artery, and striate branches of the anterior cerebral and anterior communicating arteries in perfusion‐fixed human brains by simultaneous injection of fluorescent dyes and a radio‐opaque substance in 5% gelatin. Territories were defined by ultraviolet illumination of dye and high‐resolution mammography of radio‐opaque substance. Brains were sectioned coplanar with the Talairach proportional grid system and vascular data were plotted, allowing for application to any human brain. The data suggest first that the lenticulostriate artery, recurrent artery of Heubner, and anterior choroidal artery supply distinct territories of the basal ganglia with minimal overlap and sparse anastomoses between major penetrating vessels. Individual territories are spatially consistent across brains and match the extent of major/minor infarcts. Second, branching patterns of parental, second‐, and third‐order vessels leading to circumscribed terminal vascular beds could account structurally for “lacunar” infarcts. Ann Neurol 2005