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Middle cerebral artery infarction

MedGen UID:
152845
•Concept ID:
C0740392
•
Disease or Syndrome
Synonyms: Cerebral Infarction, Middle Cerebral Artery; Infarct, MCA; Infarction, Middle Cerebral Artery; Infarcts, MCA; MCA Infarct; MCA Infarction; MCA Infarcts; Middle Cerebral Artery Circulation Infarction; Middle Cerebral Artery Infarction; Middle Cerebral Artery Stroke; Stroke, Middle Cerebral Artery
 
HPO: HP:0033762
Monarch Initiative: MONDO:0006857

Definition

Acute onset neurological deficits such as weakness, dizziness, numbness, issues with speech, or visual changes related to sudden impairment of blood flow to a part of the brain due to occlusion or rupture of the middle cerebral artery to the brain. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVMiddle cerebral artery infarction

Professional guidelines

PubMed

Malignant Middle Cerebral Artery Infarction during Early versus Late Endovascular Treatment in Acute Ischemic Stroke.
Guo W, Li N, Xu J, Ma J, Li S, Ren C, Chen J, Duan J, Ma Q, Song H, Zhao W, Ji X
Curr Neurovasc Res 2023;20(2):254-260. doi: 10.2174/1567202620666230710114443. PMID: 37431897
Decompressive craniectomy for the treatment of malignant middle cerebral artery infarction.
Mohan Rajwani K, Crocker M, Moynihan B
Br J Neurosurg 2017 Aug;31(4):401-409. Epub 2017 Jun 12 doi: 10.1080/02688697.2017.1329518. PMID: 28604106
Malignant MCA Infarction: Pathophysiology and Imaging for Early Diagnosis and Management Decisions.
Heiss WD
Cerebrovasc Dis 2016;41(1-2):1-7. Epub 2015 Nov 19 doi: 10.1159/000441627. PMID: 26581023

Recent clinical studies

Etiology

Management of the Patient with Malignant Hemispheric Stroke.
Guanci MM
Crit Care Nurs Clin North Am 2020 Mar;32(1):51-66. Epub 2019 Dec 23 doi: 10.1016/j.cnc.2019.11.003. PMID: 32014161
Decompressive Craniectomy for Malignant Middle Cerebral Artery Stroke.
Landreneau MM, Sheth KN
Semin Respir Crit Care Med 2017 Dec;38(6):737-744. Epub 2017 Dec 20 doi: 10.1055/s-0037-1607992. PMID: 29262431
Large middle cerebral artery and panhemispheric infarction.
Giossi A, Volonghi I, Del Zotto E, Costa P, Padovani A, Pezzini A
Front Neurol Neurosci 2012;30:154-7. Epub 2012 Feb 14 doi: 10.1159/000333628. PMID: 22377885
Malignant middle cerebral artery infarction.
Wartenberg KE
Curr Opin Crit Care 2012 Apr;18(2):152-63. doi: 10.1097/MCC.0b013e32835075c5. PMID: 22322256
Surgical decompression for space-occupying cerebral infarction (the Hemicraniectomy After Middle Cerebral Artery infarction with Life-threatening Edema Trial [HAMLET]): a multicentre, open, randomised trial.
Hofmeijer J, Kappelle LJ, Algra A, Amelink GJ, van Gijn J, van der Worp HB; HAMLET investigators
Lancet Neurol 2009 Apr;8(4):326-33. Epub 2009 Mar 5 doi: 10.1016/S1474-4422(09)70047-X. PMID: 19269254

Diagnosis

Malignant MCA Infarction: Pathophysiology and Imaging for Early Diagnosis and Management Decisions.
Heiss WD
Cerebrovasc Dis 2016;41(1-2):1-7. Epub 2015 Nov 19 doi: 10.1159/000441627. PMID: 26581023
Malignant hemispheric infarction of the middle cerebral artery. Diagnostic considerations and treatment options.
Godoy D, Piñero G, Cruz-Flores S, Alcalá Cerra G, Rabinstein A
Neurologia 2016 Jun;31(5):332-43. Epub 2013 Apr 17 doi: 10.1016/j.nrl.2013.02.009. PMID: 23601756
Superficial middle cerebral artery territory infarction.
González Delgado M, Bogousslavsky J
Front Neurol Neurosci 2012;30:111-4. Epub 2012 Feb 14 doi: 10.1159/000333604. PMID: 22377875
Malignant middle cerebral artery infarction.
Wartenberg KE
Curr Opin Crit Care 2012 Apr;18(2):152-63. doi: 10.1097/MCC.0b013e32835075c5. PMID: 22322256
Malignant middle cerebral artery (MCA) infarction: pathophysiology, diagnosis and management.
Treadwell SD, Thanvi B
Postgrad Med J 2010 Apr;86(1014):235-42. doi: 10.1136/pgmj.2009.094292. PMID: 20354047

Therapy

Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection.
Albers GW, Jumaa M, Purdon B, Zaidi SF, Streib C, Shuaib A, Sangha N, Kim M, Froehler MT, Schwartz NE, Clark WM, Kircher CE, Yang M, Massaro L, Lu XY, Rippon GA, Broderick JP, Butcher K, Lansberg MG, Liebeskind DS, Nouh A, Schwamm LH, Campbell BCV; TIMELESS Investigators
N Engl J Med 2024 Feb 22;390(8):701-711. Epub 2024 Feb 8 doi: 10.1056/NEJMoa2310392. PMID: 38329148
Extracranial-Intracranial Bypass and Risk of Stroke and Death in Patients With Symptomatic Artery Occlusion: The CMOSS Randomized Clinical Trial.
Ma Y, Wang T, Wang H, Amin-Hanjani S, Tong X, Wang J, Tong Z, Kuai D, Cai Y, Ren J, Wang D, Duan L, Maimaitili A, Hang C, Yu J, Bai X, Powers WJ, Derdeyn CP, Wu Y, Ling F, Gu Y, Jiao L; CMOSS Investigators
JAMA 2023 Aug 22;330(8):704-714. doi: 10.1001/jama.2023.13390. PMID: 37606672Free PMC Article
Malignant MCA Infarction: Pathophysiology and Imaging for Early Diagnosis and Management Decisions.
Heiss WD
Cerebrovasc Dis 2016;41(1-2):1-7. Epub 2015 Nov 19 doi: 10.1159/000441627. PMID: 26581023
Malignant middle cerebral artery (MCA) infarction: pathophysiology, diagnosis and management.
Treadwell SD, Thanvi B
Postgrad Med J 2010 Apr;86(1014):235-42. doi: 10.1136/pgmj.2009.094292. PMID: 20354047
Music listening enhances cognitive recovery and mood after middle cerebral artery stroke.
Särkämö T, Tervaniemi M, Laitinen S, Forsblom A, Soinila S, Mikkonen M, Autti T, Silvennoinen HM, Erkkilä J, Laine M, Peretz I, Hietanen M
Brain 2008 Mar;131(Pt 3):866-76. doi: 10.1093/brain/awn013. PMID: 18287122

Prognosis

Management of the Patient with Malignant Hemispheric Stroke.
Guanci MM
Crit Care Nurs Clin North Am 2020 Mar;32(1):51-66. Epub 2019 Dec 23 doi: 10.1016/j.cnc.2019.11.003. PMID: 32014161
Malignant MCA Infarction: Pathophysiology and Imaging for Early Diagnosis and Management Decisions.
Heiss WD
Cerebrovasc Dis 2016;41(1-2):1-7. Epub 2015 Nov 19 doi: 10.1159/000441627. PMID: 26581023
Malignant middle cerebral artery infarction.
Wartenberg KE
Curr Opin Crit Care 2012 Apr;18(2):152-63. doi: 10.1097/MCC.0b013e32835075c5. PMID: 22322256
Decompressive hemicraniectomy after malignant middle cerebral artery infarction: rationale and controversies.
Arnaout OM, Aoun SG, Batjer HH, Bendok BR
Neurosurg Focus 2011 Jun;30(6):E18. doi: 10.3171/2011.3.FOCUS1160. PMID: 21631219
Malignant middle cerebral artery infarction: clinical characteristics, treatment strategies, and future perspectives.
Huttner HB, Schwab S
Lancet Neurol 2009 Oct;8(10):949-58. doi: 10.1016/S1474-4422(09)70224-8. PMID: 19747656

Clinical prediction guides

Characterizing Diaschisis-Related Thalamic Perfusion and Diffusion After Middle Cerebral Artery Infarction.
Xia C, Zhou J, Lu C, Wang Y, Tang T, Cai Y, Ju S
Stroke 2021 Jul;52(7):2319-2327. Epub 2021 May 11 doi: 10.1161/STROKEAHA.120.032464. PMID: 33971741
Prediction of Malignant Middle Cerebral Artery Infarction in Elderly Patients.
Goto Y, Kumura E, Watabe T, Nakamura H, Nishino A, Koyama T, Taniwaki K, Yuguchi T, Yoshimine T
J Stroke Cerebrovasc Dis 2016 Jun;25(6):1389-95. Epub 2016 Apr 20 doi: 10.1016/j.jstrokecerebrovasdis.2015.12.034. PMID: 27009609
Decompressive hemicraniectomy for malignant middle cerebral artery territory infarction: is life worth living?
Rahme R, Zuccarello M, Kleindorfer D, Adeoye OM, Ringer AJ
J Neurosurg 2012 Oct;117(4):749-54. Epub 2012 Aug 24 doi: 10.3171/2012.6.JNS111140. PMID: 22920962
Malignant middle cerebral artery infarction: clinical characteristics, treatment strategies, and future perspectives.
Huttner HB, Schwab S
Lancet Neurol 2009 Oct;8(10):949-58. doi: 10.1016/S1474-4422(09)70224-8. PMID: 19747656
Predictors of life-threatening brain edema in middle cerebral artery infarction.
Hofmeijer J, Algra A, Kappelle LJ, van der Worp HB
Cerebrovasc Dis 2008;25(1-2):176-84. Epub 2008 Jan 23 doi: 10.1159/000113736. PMID: 18212524

Recent systematic reviews

Endovascular clot retrieval for M2 segment middle cerebral artery occlusion: a systematic review and meta-analysis.
Findakly S, Maingard J, Phan K, Barras CD, Jhamb A, Chandra R, Thijs V, Brooks M, Asadi H
Intern Med J 2020 May;50(5):530-541. doi: 10.1111/imj.14333. PMID: 31059208
Decompressive Hemicraniectomy in the Treatment of Malignant Middle Cerebral Artery Infarction: A Meta-Analysis.
Das S, Mitchell P, Ross N, Whitfield PC
World Neurosurg 2019 Mar;123:8-16. Epub 2018 Nov 27 doi: 10.1016/j.wneu.2018.11.176. PMID: 30500591
Endovascular Mechanical Thrombectomy for Acute Middle Cerebral Artery M2 Segment Occlusion: A Systematic Review.
Chen CJ, Wang C, Buell TJ, Ding D, Raper DM, Ironside N, Paisan GM, Starke RM, Southerland AM, Liu K, Worrall BB
World Neurosurg 2017 Nov;107:684-691. Epub 2017 Aug 24 doi: 10.1016/j.wneu.2017.08.108. PMID: 28844911
Decompressive hemicraniectomy for malignant middle cerebral artery territory infarction: is life worth living?
Rahme R, Zuccarello M, Kleindorfer D, Adeoye OM, Ringer AJ
J Neurosurg 2012 Oct;117(4):749-54. Epub 2012 Aug 24 doi: 10.3171/2012.6.JNS111140. PMID: 22920962
Predictors of life-threatening brain edema in middle cerebral artery infarction.
Hofmeijer J, Algra A, Kappelle LJ, van der Worp HB
Cerebrovasc Dis 2008;25(1-2):176-84. Epub 2008 Jan 23 doi: 10.1159/000113736. PMID: 18212524

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