![]() The longitudinal distance between the most lateral points of the anterior and posterior horns of the lateral ventricle (AP), and that between the center of the lesion and the most lateral point of the posterior horn of the lateral ventricle (LP) were measured ( Figure, A). The anteroposterior and mediolateral localization of the lesion was assessed at the level of the corona radiata showing the insula cortex and the lateral ventricle on T2WI. The lesion size was measured as the longest diameter of the lesion on T2WI. The acute lesion responsible for the patient’s weakness was identified using DWI. A corona radiata lesion partially extending into the basal ganglia was included.Īll patients underwent brain MRI including T2-weighted image (T2WI, 1.5T, TR, 5000 ms TE, 80 ms) and diffusion-weighted image (DWI, b=1000 s/mm 2 TR, 6000 ms TE, 84 ms), and MR angiogram covering the cerebral and carotid arteries within 3 days after admission. The inclusion criteria were (1) isolated arm, leg, bulbar, or bulbofacial paresis, (2) absence of any sensory disturbance or significant ataxia, and (3) the lesion was less than 2 cm in size and the location of it was restricted to the corona radiata adjacent to the lateral ventricle without involving the internal capsule. The author studied the consecutive 28 patients who developed isolated monoparesis after an acute infarct in the corona radiata, selected from all patients who were admitted to Dankook University Hospital because of a first-ever stroke between February 2000 and July 2006. The author assessed the anteroposterior and mediolateral topography of the lesions in patients with isolated arm, leg, bulbar, or bulbofacial weakness, so called monoparesis in a broad sense caused by a small subcortical infarct to investigate more definite somatotopic organization of motor fibers in the corona radiata. Moreover, the topographic distribution was investigated only in the anterior-to-posterior direction although the motor cortex is somatotopically arranged in the medial-to-lateral direction. Although a few studies reported the presence of somatotopy in the corona radiata in patients with a small subcortical infarct, 4–6 the patients’ motor deficits were not confined to a single part of the body, which obscured the precise topographic association of the lesion with a specific body part. However, the data are still insufficient in human. 1–4 It has been suggested that the descending motor fibers emerging from the cortical motor strip maintain the somatotopic arrangement in the corona radiata. The somatotopic organization of the corticospinal system is important because it is related to certain stroke syndromes. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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