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Departments of Neurology, (Drs. Caplan, Babikian, Helgason, Hier, and Stein) and Radiology (Neuroradiology) (Dr. Patel), Michael Reese Hospital and University of Chicago Pritzker School of Medicine, Chicago, IL; and the Department of Neurology (Dr. DeWitt), Massachusetts General Hospital, Harvard Medical School, Boston, MA.
We studied 20 patients with severe occlusive disease of the mainstem middle cerebral artery (MCA) or its major division branches, and 25 patients with internal carotid artery (ICA) disease. MCA disease patients were more often black, female, younger, and had fewer TIAs than the ICA disease patients. Neurologic signs in patients with MCA disease evolved progressively during days to weeks, whereas ICA disease patients more often had an acute onset of nonprogressive deficits. CT commonly showed restricted subcortical or wedge-shaped infarcts in MCA disease patients. All MCA disease patients had stroke, but 40% of ICA disease patients had no infarction. MCA lesions usually affected the mainstem MCA or its major superior division. Patients with MCA disease seldom had recurrent ischemia in the same vascular territory as the stroke and had a low incidence of subsequent cardiac death.
Addres correspondence and reprint requests to Dr. Caplan, Department of Neurology, Michael Reese Hospital, Lake Shore Drive at 31st Street, Chicago, IL 60616.
Supported by a grant from the AMOCO Foundation and NIH Contract N01-NS-2-2399.
Accepted for publication October 18, 1984.
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