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Middle cerebral artery syndrome

MedGen UID:
66766
•Concept ID:
C0238281
•
Disease or Syndrome
Synonym: Middle Cerebral Artery Syndrome
SNOMED CT: Middle cerebral artery syndrome (195209007)

Definition

A common stroke syndrome caused by infarction of the cerebral territories supplied by the middle cerebral artery (MCA). As the areas of the brain perfused by the MCA are extensive, symptoms vary widely but may be characterized by hemiparesis, hemianopia, hemineglect and aphasia. [from NCI]

Professional guidelines

PubMed

Management of Tumor- and Nontumor-related Aorto-esophageal and Aorto-bronchial Fistulas.
Omran S, Ardalani L, Beyer K, De Bucourt M, Gombert A, Buerger M, Frese JPB, Greiner A
Ann Vasc Surg 2021 Apr;72:419-429. Epub 2020 Nov 21 doi: 10.1016/j.avsg.2020.10.009. PMID: 33227472
Management of a wake-up stroke.
Huang X, Alakbarzade V, Khandanpour N, Pereira AC
Pract Neurol 2019 Aug;19(4):326-331. Epub 2019 Mar 14 doi: 10.1136/practneurol-2018-002179. PMID: 30872357
Management of the malignant middle cerebral artery syndrome.
Hwang DY, Matouk CC, Sheth KN
Semin Neurol 2013 Nov;33(5):448-55. Epub 2014 Feb 6 doi: 10.1055/s-0033-1364211. PMID: 24504607

Recent clinical studies

Etiology

Management of Tumor- and Nontumor-related Aorto-esophageal and Aorto-bronchial Fistulas.
Omran S, Ardalani L, Beyer K, De Bucourt M, Gombert A, Buerger M, Frese JPB, Greiner A
Ann Vasc Surg 2021 Apr;72:419-429. Epub 2020 Nov 21 doi: 10.1016/j.avsg.2020.10.009. PMID: 33227472
Management of a wake-up stroke.
Huang X, Alakbarzade V, Khandanpour N, Pereira AC
Pract Neurol 2019 Aug;19(4):326-331. Epub 2019 Mar 14 doi: 10.1136/practneurol-2018-002179. PMID: 30872357
Efficacy of decompressive craniectomy in the management of intracranial pressure in severe traumatic brain injury.
Yue JK, Rick JW, Deng H, Feldman MJ, Winkler EA
J Neurosurg Sci 2019 Aug;63(4):425-440. Epub 2017 Nov 7 doi: 10.23736/S0390-5616.17.04133-9. PMID: 29115100
Hemicraniectomy for Malignant Middle Cerebral Artery Syndrome: A Review of Functional Outcomes in Two High-Volume Stroke Centers.
Pandhi A, Tsivgoulis G, Goyal N, Ishfaq MF, Male S, Boviatsis E, Chang JJ, Zand R, Voumvourakis K, Elijovich L, Alexandrov AW, Malkoff MD, Hoit D, Arthur AS, Alexandrov AV
J Stroke Cerebrovasc Dis 2018 Sep;27(9):2405-2410. doi: 10.1016/j.jstrokecerebrovasdis.2018.04.031. PMID: 29776804
Management of the malignant middle cerebral artery syndrome.
Hwang DY, Matouk CC, Sheth KN
Semin Neurol 2013 Nov;33(5):448-55. Epub 2014 Feb 6 doi: 10.1055/s-0033-1364211. PMID: 24504607

Diagnosis

The Utility of Vessel Wall Imaging in the Postulation of Acute Ischemic Stroke With Spontaneous Recanalization Pathophysiology.
Md Noh MSF, Abdul Rashid AM, Hoo FK, Bahari N
Top Magn Reson Imaging 2022 Aug 1;31(4):40-42. Epub 2022 Sep 13 doi: 10.1097/RMR.0000000000000298. PMID: 36122324Free PMC Article
Prevalence of sleep apnea at the acute phase of ischemic stroke with or without thrombolysis.
Huhtakangas JK, Huhtakangas J, Bloigu R, Saaresranta T
Sleep Med 2017 Dec;40:40-46. Epub 2017 Oct 7 doi: 10.1016/j.sleep.2017.08.018. PMID: 29221777
Management of the malignant middle cerebral artery syndrome.
Hwang DY, Matouk CC, Sheth KN
Semin Neurol 2013 Nov;33(5):448-55. Epub 2014 Feb 6 doi: 10.1055/s-0033-1364211. PMID: 24504607
Viral encephalitis and atherothrombotic stroke.
Garcia AM, Egido JA, Simal P
BMJ Case Rep 2012 Nov 1;2012 doi: 10.1136/bcr.10.2011.5022. PMID: 23125293Free PMC Article
Critical care management of subarachnoid hemorrhage and ischemic stroke.
Seder DB, Mayer SA
Clin Chest Med 2009 Mar;30(1):103-22, viii-ix. doi: 10.1016/j.ccm.2008.11.004. PMID: 19186283

Therapy

Management of Tumor- and Nontumor-related Aorto-esophageal and Aorto-bronchial Fistulas.
Omran S, Ardalani L, Beyer K, De Bucourt M, Gombert A, Buerger M, Frese JPB, Greiner A
Ann Vasc Surg 2021 Apr;72:419-429. Epub 2020 Nov 21 doi: 10.1016/j.avsg.2020.10.009. PMID: 33227472
Efficacy of decompressive craniectomy in the management of intracranial pressure in severe traumatic brain injury.
Yue JK, Rick JW, Deng H, Feldman MJ, Winkler EA
J Neurosurg Sci 2019 Aug;63(4):425-440. Epub 2017 Nov 7 doi: 10.23736/S0390-5616.17.04133-9. PMID: 29115100
Hemicraniectomy for Malignant Middle Cerebral Artery Syndrome: A Review of Functional Outcomes in Two High-Volume Stroke Centers.
Pandhi A, Tsivgoulis G, Goyal N, Ishfaq MF, Male S, Boviatsis E, Chang JJ, Zand R, Voumvourakis K, Elijovich L, Alexandrov AW, Malkoff MD, Hoit D, Arthur AS, Alexandrov AV
J Stroke Cerebrovasc Dis 2018 Sep;27(9):2405-2410. doi: 10.1016/j.jstrokecerebrovasdis.2018.04.031. PMID: 29776804
Prevalence of sleep apnea at the acute phase of ischemic stroke with or without thrombolysis.
Huhtakangas JK, Huhtakangas J, Bloigu R, Saaresranta T
Sleep Med 2017 Dec;40:40-46. Epub 2017 Oct 7 doi: 10.1016/j.sleep.2017.08.018. PMID: 29221777
Management of the malignant middle cerebral artery syndrome.
Hwang DY, Matouk CC, Sheth KN
Semin Neurol 2013 Nov;33(5):448-55. Epub 2014 Feb 6 doi: 10.1055/s-0033-1364211. PMID: 24504607

Prognosis

Posterior Reversible Encephalopathy Syndrome Caused by Induced Hypertension to Treat Cerebral Vasospasm Secondary to Aneurysmal Subarachnoid Hemorrhage.
Elsamadicy AA, Koo AB, Reeves BC, Sujijantarat N, David WB, Malhotra A, Gilmore EJ, Matouk CC, Hebert R
World Neurosurg 2020 Nov;143:e309-e323. Epub 2020 Jul 25 doi: 10.1016/j.wneu.2020.07.135. PMID: 32721559
Hemicraniectomy for Malignant Middle Cerebral Artery Syndrome: A Review of Functional Outcomes in Two High-Volume Stroke Centers.
Pandhi A, Tsivgoulis G, Goyal N, Ishfaq MF, Male S, Boviatsis E, Chang JJ, Zand R, Voumvourakis K, Elijovich L, Alexandrov AW, Malkoff MD, Hoit D, Arthur AS, Alexandrov AV
J Stroke Cerebrovasc Dis 2018 Sep;27(9):2405-2410. doi: 10.1016/j.jstrokecerebrovasdis.2018.04.031. PMID: 29776804
The Wessex modified Richmond Sedation Scale as a novel tool for monitoring patients at risk of malignant MCA syndrome.
Hayat TTA, Myers MA, Hell J, Cordingly M, Bulters DO, Weir N, Pengas G
Acta Neurochir (Wien) 2018 Jun;160(6):1115-1119. Epub 2018 Apr 11 doi: 10.1007/s00701-018-3531-y. PMID: 29644406
Decompressive surgery for malignant middle cerebral artery syndrome.
Lee SC, Wang YC, Huang YC, Tu PH, Lee ST
J Clin Neurosci 2013 Jan;20(1):49-52. Epub 2012 Oct 12 doi: 10.1016/j.jocn.2012.05.027. PMID: 23063497
Decompressive hemicraniectomy, strokectomy, or both in the treatment of malignant middle cerebral artery syndrome.
Kostov DB, Singleton RH, Panczykowski D, Kanaan HA, Horowitz MB, Jovin T, Jankowitz BT
World Neurosurg 2012 Nov;78(5):480-6. Epub 2011 Dec 24 doi: 10.1016/j.wneu.2011.12.080. PMID: 22381279

Clinical prediction guides

Hemicraniectomy for Malignant Middle Cerebral Artery Syndrome: A Review of Functional Outcomes in Two High-Volume Stroke Centers.
Pandhi A, Tsivgoulis G, Goyal N, Ishfaq MF, Male S, Boviatsis E, Chang JJ, Zand R, Voumvourakis K, Elijovich L, Alexandrov AW, Malkoff MD, Hoit D, Arthur AS, Alexandrov AV
J Stroke Cerebrovasc Dis 2018 Sep;27(9):2405-2410. doi: 10.1016/j.jstrokecerebrovasdis.2018.04.031. PMID: 29776804
The Wessex modified Richmond Sedation Scale as a novel tool for monitoring patients at risk of malignant MCA syndrome.
Hayat TTA, Myers MA, Hell J, Cordingly M, Bulters DO, Weir N, Pengas G
Acta Neurochir (Wien) 2018 Jun;160(6):1115-1119. Epub 2018 Apr 11 doi: 10.1007/s00701-018-3531-y. PMID: 29644406
Prevalence of sleep apnea at the acute phase of ischemic stroke with or without thrombolysis.
Huhtakangas JK, Huhtakangas J, Bloigu R, Saaresranta T
Sleep Med 2017 Dec;40:40-46. Epub 2017 Oct 7 doi: 10.1016/j.sleep.2017.08.018. PMID: 29221777
Verapamil-induced breakdown of the blood-brain barrier presenting as a transient right middle cerebral artery syndrome.
Pace J, Nelson J, Ray A, Hu Y
Interv Neuroradiol 2017 Dec;23(6):601-604. Epub 2017 Sep 28 doi: 10.1177/1591019917729822. PMID: 28956514Free PMC Article
Decompressive hemicraniectomy, strokectomy, or both in the treatment of malignant middle cerebral artery syndrome.
Kostov DB, Singleton RH, Panczykowski D, Kanaan HA, Horowitz MB, Jovin T, Jankowitz BT
World Neurosurg 2012 Nov;78(5):480-6. Epub 2011 Dec 24 doi: 10.1016/j.wneu.2011.12.080. PMID: 22381279

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