From the Research
A right internal capsule/corona radiata infarct is a type of stroke that requires immediate treatment with antiplatelet therapy, such as aspirin 325mg initially, followed by 81mg daily long-term, and consideration of intravenous tissue plasminogen activator (tPA) if presenting within 4.5 hours of symptom onset, as this approach has been shown to improve functional outcomes 1. The location of the infarct is significant, as the internal capsule and corona radiata contain densely packed nerve fibers connecting the cerebral cortex to the brainstem and spinal cord, explaining why damage to this small area can cause widespread neurological deficits, including left-sided weakness or paralysis, sensory deficits, and possibly cognitive issues 2. Some key points to consider in the management of this condition include:
- Secondary prevention, which includes blood pressure control (target <130/80 mmHg), statin therapy (such as atorvastatin 40-80mg daily), and management of other risk factors like diabetes and smoking cessation 3
- Early initiation of physical therapy, occupational therapy, and speech therapy for rehabilitation, as this can help improve functional outcomes and reduce the risk of long-term disability 4
- The use of diffusion tensor imaging (DTI) to predict motor outcome, as this technique has been shown to be effective in predicting functional outcomes in patients with intracerebral hemorrhage 3
- The importance of considering the location of the infarct, as infarcts involving the corona radiata and internal capsule can have different clinical and imaging features, and may require different management approaches 5, 4 Overall, the management of a right internal capsule/corona radiata infarct requires a comprehensive approach that takes into account the location and severity of the infarct, as well as the patient's overall medical condition and risk factors, with the goal of improving functional outcomes and reducing the risk of long-term disability.