Original Articles| Volume 12, ISSUE 2, P66-73, March 2003

Download started.


Spectrum of single and multiple corona radiata infarcts: Clinical/MRI correlations


      We sought to determine the clinical pictures, topography and pathogenesis of patients with unilateral single or multiple corona radiata infarcts. We defined corona radiata ischemic stroke if the patient had a focal neurological deficit and a relevant non-hemorrhagic infarction confined to the vascular territory of a long medullary artery proved by CT and MRI with contrast. We compared risk factors and clinical feature between subtypes of corona radiata infarcts. The study sample represents 1,2% of the patients (68/5500) with first-ever stroke in our Registry, including ischemic and hemorrhagic strokes. There were 37 patients (54%) with single infarct presenting 17 different complete or partial sensory-motor symptoms with dysarthria; 14 patients (21%) with unilateral multiple infarcts in one hemisphere had oftenly complete sensorimotor deficits with some neuropsychological impairment; among 17 patients (25%) with multiple infarcts in both hemisphere, one half had bilateral motor and sensory symptoms, and neuropsychological deficits, visual field defects were uncommon. Seventeen patients (25%) had dysarthria, which was no localizing value. Hypertension was the most frequent vascular risk factor in 62% of patients, smoking in 28%, diabetes mellitus in 26%, hypercholesterolemia in 9%, and atrial fibrillation in 7%. The main cause of corona radiata infarcts was small-artery disease with long-standing hypertension in 40 patients (59%), large-artery disease in 19%, cardioembolism in 12%. Most of the patients (88%) had leukoaraiosis, and patients with bilateral multiple infarcts, leukoaraiosis was more frequent than in those with unilateral single infarct (P =.016; <.05). Despite clinical similarity to that found in superficial and deep infarcts, incomplete motor and sensory symptoms and MRI allows to delineate simultaneous uni- or multiple infarcts in the corona radiata. After an acute and immediate onset, outcome at 6 months of stroke onset is in general benign except those with bilateral infarcts. The coexistence of small-artery disease with leukoaraiosis suggest similar vascular risk factors and physiopathological mechanism. Copyright © 2003 by National Stroke Association


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Stroke and Cerebrovascular Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • De Reuck J
        The human periventricular arterial blood supply and the anatomy of cerebral infarctions.
        Eur Neurol. 1971; 5: 321-334
        • Ghika JA
        • Bogousslavsky J
        • Regli F
        Deep perforators from the carotid system: template of the vascular territories.
        Arch Neurol. 1990; 47: 1097-1100
        • Pullicino PM
        The course and territories of cerebral small arteries.
        Adv Neurol. 1993; 62: 11-41
        • Tatu L
        • Moulin T
        • Bogousslavsky J
        • et al.
        Arterial territories of human brain.
        in: Stroke Syndromes. Cambridge University Press, Cambridge, UK2001: 371-404
        • Bogousslavsky J
        • Regli F
        Borderzone infarction distal to internal carotid artery occlusion.
        Ann Neurol. 1986; 20: 346-350
        • Bogousslavsky J
        • Regli F
        Unilateral watershed cerebral infarcts.
        Neurology. 1986; 36: 373-377
        • Angeloni U
        • Bozzao L
        • Fantozzi L
        • et al.
        Internal border zone infarction following acute middle cerebral artery occlusion.
        Neurology. 1990; 40: 1196-1198
        • Bladin CE
        • Chambers BR
        Clinical features, pathogenesis, and computed tomographic characteristics of internal watershed infarction.
        Stroke. 1993; 24: 1925-1932
        • Hachinski VC
        • Potter P
        • Merskey H
        Arch Neurol. 1987; 44: 21-23
        • Junqué C
        • Pujol J
        • Vendrell P
        • et al.
        Leuko-araiosis on MRI and speed of mental processing.
        Arch Neurol. 1990; 47: 151-156
        • Burger PC
        • Vogel FS
        Hemorrhagic white matter infarction in three critically ill patients.
        Hum Pathol. 1977; 8: 121-132
        • Breteler MMB
        • Van Swieten JC
        • Bots ML
        • et al.
        Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study.
        Neurology. 1994; 44: 1246-1252
        • Read SJ
        • Pettigrew L
        • Schimmel L
        • et al.
        White matter medullary infarcts: acute subcortical infarction in the centrum ovale.
        Cerebrovasc Dis. 1998; 8: 289-295
        • Gutmann DH
        • Scherer S
        MRI of ataxic hemiparesis localized to the corona radiata.
        Stroke. 1989; 20: 1571-1573
        • Bogousslavsky J
        • Regli F
        Centrum ovale infarcts; subcortical infarction in the superficial territory of the middle cerebral artery.
        Neurology. 1992; 42: 1992-1998
        • Kim JS
        Pure dysarthria, isolated facial paresis, or dysarthria-facial paresis syndrome.
        Stroke. 1994; 25: 1994-1998
        • Leys D
        • Mounier-Vehier F
        • Rondepierre PH
        • et al.
        Small infarcts in the centrum ovale: predisposing factors.
        Cerebrovasc Dis. 1994; 4: 83-87
        • Kumral E
        • Ozkaya B
        • Sagduyu A
        • et al.
        The Ege stroke registry: A hospital-based study in the Aegean Region, İzmir, Turkey.
        Cerebrovasc Dis. 1998; 8: 278-288
        • Moody DM
        • Bell MA
        • Challa VR
        Features of the cerebral vascular pattern that predict vulnerability to perfusion or oxygenation deficiency: An anatomic study.
        AJNR. 1990; 11: 431-439
        • De Reuck J
        • Crevits L
        • De Coster W
        • et al.
        Pathogenesis of Binswanger chronic progressive subcortical encephalopathy.
        Neurology. 1980; 30: 920-928
        • Melo TP
        • Bogousslavsky J
        • van Melle G
        • et al.
        Pure motor stroke: A reappraisal.
        Neurology. 1992; 42: 789-798
        • Blecic SA
        • Bogousslavsky J
        • Van Melle G
        • et al.
        Isolated sensorimotor stroke: a reevaluation of clinical, topographic and etiological patterns.
        Cerebrovasc Dis. 1993; 3: 357-363
        • Staff G
        • Samuelsson M
        • Lindgren A
        • et al.
        Sensorimotor stroke; clinical features, MRI findings, and cardiac and vascular concomitants in 32 patients.
        Acta Neurol Scand. 1998; 97: 93-98
        • Schwab RS
        • England AC
        Parkinson syndromes due to various specific causes.
        in: Handbook of Clinical Neurology. vol 6. Elsevier, Amsterdam, North Holland1968: 227-247
      1. Parkinsonism in patients with cerebral infarcts: Clin Neurol Neurosurg. 1980; 82-3: 177-185
        • Van Zagten M
        • Lodder J
        • Kessels F
        Gait disorder and parkinsonian signs in patients with stroke related to small deep infarcts and white matter lesions.
        Mov Disord. 1998; 13: 89-95
        • Waterston JA
        • Brown M
        • Butter P
        • et al.
        Small dep cerebral infarcts associated with occlusive internal caroid artery disease: a hemodynamic phenomenon?.
        Arch Neurol. 1990; 47: 953-957
        • Boiten J, Rothwell PM, Slattery J, et al, for the European Carotid Surgery Trialists' Collaborative Group
        Frequency and degree of carotid stenosis in small centrum ovale infarcts as compared to lacunar infarcts.
        Cerebrovasc Dis. 1997; 7: 138-143