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Journal of the Korean Geriatrics Society 2004;8(4):252-255.
Published online December 31, 2004.
Posterior Circulation Infarction Leading to Malignant MCA Infarction
Jong Ho Park
악성 중뇌동맥 경색을 초래한 후방 순환계 뇌경색 1예
Malignant MCA(middle cerebral artery) infarction is one of the leading cause of fatal stroke. It is usually caused by occlusion of the ipsilateral MCA or ICA(internal carotid artery). We report a 62-year-old man with posterior circulation stroke(distal basilar artery occlusion) which was later developed in malignant MCA infarction. MRI(magnetic resonance imaging) revealed high signal intensities in more than 2/3 of the right hemispheres and also in the bilateral thalamus, occipital cortices extending to the midbrain, pons and right SCA(superior cerebellar artery) territory of the cerebellum. Ipsilateral ICA and MCA of the infarcted hemisphere were not visible but ipsilateral PCA(posterior cerebral artery) seemed to be relatively prominent compared with the contralateral side in MR Angiography. From the pont of view of the initial pathologic brainstem sign and MR findings, we suggest that embolic occlusion of the distal basilar artery might be responsible for malignant right MCA infarction in this patient, from which the right PCA had dominantly supplied the most of the ipsilateral hemisphere.
초 록

악성 중뇌동맥 경색은 중뇌동맥의 완전 폐색이나 반구 전체의 경색으로 심한 뇌부종을 초래하여 발생 2일에서 5일 이내에 뇌사로 진행하는 치명적인 뇌졸중을 말한다. 저자들은 우측 내경동맥과 중뇌동맥이 없어 우측 중뇌동맥영역을 동측 후뇌동맥의 주된 공급을 받아 온 62세의 고혈압과 당뇨의 병력을 가진 남자로서, 후방순환계인 기저동맥 말단부 폐색으로 인해 악성 중뇌동맥징후를 보였던, 비교적 특이한 경우를 경험하였기에 이를 보고하는 바이다.

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