From the Guidelines
An acute infarction in the right capsuloganglionic region and the right corona radiata can result in ataxia with hemiparesis.
Clinical Implications
- The capsuloganglionic region, which includes the internal capsule and basal ganglia, plays a crucial role in motor control, and an infarct in this area can lead to hemiparesis [ 1 ].
- The corona radiata, a region of white matter in the brain, is involved in the transmission of motor signals, and damage to this area can also contribute to motor deficits.
- Ataxia, which refers to a loss of coordination and balance, can occur when the cerebellum or its connections are affected, but in this case, it is likely due to the involvement of the corona radiata and internal capsule [ 1 ].
Diagnostic Considerations
- Imaging studies, such as computed tomography (CT) or magnetic resonance imaging (MRI), are essential for diagnosing and localizing the infarct [ 1 ].
- Perfusion imaging, which assesses blood flow to the brain, can help identify areas of ischemia and guide treatment decisions [ 1 ].
Treatment and Management
- The management of an acute infarction in the right capsuloganglionic region and the right corona radiata typically involves acute stroke care, including thrombolysis or endovascular revascularization, if indicated [ 1 ].
- Rehabilitation and physical therapy are also crucial for helping patients recover from motor deficits and ataxia.
From the Research
Implications of Acute Infarction
The implications of an acute infarction in the right capsuloganglionic region and the right corona radiata can be understood by examining the effects of infarcts in these areas on patient outcomes.
- Infarcts involving the corona radiata have been associated with larger infarct volumes and higher NIHSS scores at admission and discharge 2.
- The corona radiata is a critical area for motor function, and infarcts in this region can result in significant motor impairment 3, 4.
- Infarcts in the basal ganglia and corona radiata have been linked to executive dysfunction after acute infarct 5.
- The right corona radiata is particularly important, as infarcts in this region have been associated with more severe symptoms at discharge 2.
Clinical Correlations
Clinical correlations of infarcts in the right capsuloganglionic region and the right corona radiata include:
- Motor impairment, including arm motor impairment 3.
- Executive dysfunction, including initiation and perseveration deficits 5.
- Sensory-motor symptoms, including dysarthria 4.
- Neuropsychological impairment, including cognitive deficits 4, 5.
Prognosis
The prognosis for patients with acute infarction in the right capsuloganglionic region and the right corona radiata is generally unfavorable, with a higher likelihood of: