From the Research
No, the right corona radiata lacunar infarct and right inferior frontal infarct would not be supplied by the P2 segment and distal right posterior cerebral artery (PCA). These lesions are more likely supplied by branches of the middle cerebral artery (MCA) and/or anterior cerebral artery (ACA) 1. The corona radiata receives blood supply primarily from lenticulostriate branches of the MCA and perforating branches of the ACA. The inferior frontal region is typically supplied by branches of the MCA. The posterior cerebral artery (PCA), including its P2 segment, mainly supplies the occipital lobe, medial and inferior temporal lobe, thalamus, and parts of the midbrain. This vascular distribution explains why lesions in the corona radiata and inferior frontal regions would not result from PCA territory ischemia but rather from disruptions in the anterior circulation (MCA/ACA territories) 2.
Some key points to consider:
- Lacunar infarcts are small subcortical infarcts that occur due to disease of the small penetrating arteries, and they are not typically associated with large areas of perfusion deficits that extend beyond the subcortical region to the cortical region 3.
- The most recent and highest quality study available, which was published in 2016, suggests that infarct size may distinguish the pathogenesis of lacunar infarction of the middle cerebral artery territory, with smaller infarcts being more likely to be caused by small vessel disease (SVD) rather than branch atheromatous disease (BAD) 1.
- The evidence from the study published in 2011, which examined infarctions in the vascular territory of the posterior cerebral artery, found that lacunar stroke is the main subtype of infarction occurring in the PCA territory, but this does not apply to the corona radiata and inferior frontal regions 2.
- The study published in 2006, which discussed lacunar infarct, highlights the importance of considering the underlying mechanism of the infarct, including microatheroma, lipohyalinosis, fibrinoid necrosis, and Charcot-Bouchard aneurysm, but does not provide specific information about the vascular supply of the corona radiata and inferior frontal regions 4.
Overall, based on the most recent and highest quality evidence, the right corona radiata lacunar infarct and right inferior frontal infarct are not supplied by the P2 segment and distal right posterior cerebral artery (PCA), but rather by branches of the MCA and/or ACA.