Striatocapsular Infarction; a Single Institutional Experience
Osama Shukir Muhammed Amin, Araz Aziz Abdullah, Amanj Xaznadar, Mohammad Shaikhani
Acta Inform Med. 2012; 20(2): 106-112

View PDF Fulltext


Objective: Striatocapsular infarction is an uncommon form of deep hemispheric strokes. We analyzed the clinical presentation of this stroke to determine its core features and neurological outcome. Material and methods: This prospective, observational, short-term longitudinal study was carried out from November 1, 2009 to October 30, 2011 in the department of neurology, Sulaimaniya general teaching hospital, Iraq and involved 13 consecutive Kurdish patients who were diagnosed with striatocapsular infarction radiologically; all patients underwent routine blood tests, resting 12-lead ECG, transthoracic echocardiography, and urgent non-contrast CT brain scanning at the time of admission. All patients were reassessed clinically after 3 months. Results: Nine patients (69%) were females and 7 patients (53%) were older than 50 years of age. Infarction of the right lenticular nucleus was more common than the left one. Severe flaccid hemiplegia dominated the clinical presentation. Speech and language dysfunction were found in 4 patients (30%) while inattention and neglect were detected in 8 patients (61%). At 3 months, 4 patients were bed-ridden and 4 were wheel-chair bound; dystonia and involuntary movements did not occur. Only the patient with bilateral infarction demonstrated Parkinsonism. Conclusion: Striatocapsular infraction in Iraqi Kurdish patients was more common in females and at the right lenticular nucleus. Hypertension, smoking, and hypercholesterolemia were the commonest risk factors. Dense hemiplegia was the commonest presentation; the functional outcome was poor in the majority. After 3 months of the ischemic event, involuntary movements and dystonia were not seen, and Parkinsonism was found in one patient only.


1. Chakravarthy VS, Joseph D, Bapi RS. What do the basal ganglia do? A modeling perspective. Biol Cybern. 2010; 103(3): 237-253.

2. Stocco A, Lebiere C, Anderson JR. Conditional routing of information to the cortex: a model of the basal ganglia’s role in cognitive coordination. Psychol Rev. 2010; 117(2): 541-574.

3. Hikosaka O, Takikawa Y, Kawagoe R. Role of the basal ganglia in the control of purposive saccadic eye movements. Physiol Rev. 2000; 80(3): 953-978.

4. Adams HP Jr, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007; 38(5): 1655-1711.

5. Bladin PF, Berkovic SF. Striatocapsular infarction: large infarcts in the lenticulostriate arterial territory. Neurology. 1984; 34(11): 1423-1430.

6. Fisher CM, Curry HB. Pure motor hemiplegia of vascular origin. Arch Neurol. 1965; 13: 30-44.

7. Fisher CM. Lacunes: small, deep cerebral infarcts. Neurology. 1965; 15: 774-784.

8. Fisher CM. The arterial lesions underlying lacunes. Acta Neuropathol. 1965; 12(1): 1-15.

9. Fisher CM, Cole M. Homolateral ataxia and crural paresis; A vascular syndrome. J Neurol Neurosurg Psychiatry. 1965; 28(1): 48-55.

10. Fisher CM. Pure sensory stroke involving face, arm, and leg. Neurology. 1965; 15: 76-80.

11. Fisher CM. A lacunar stroke: The dysarthria-clumsy hand syndrome. Neurology. 1967; 17: 614-617.

12. Fisher CM. Thalamic pure sensory stroke: A pathologic study. Neurology. 1978; 28; 1141-1144.

13. Fisher CM. Lacunar strokes and infarcts: a review. Neurology. 1982; 32(8): 871-876.

14. Mohr JP. Progress in cerebrovascular disease; lacunes. Stroke. 1982; 13(1): 3-11.

15. Fisher CM. Capsular infarcts: The underlying vascular lesions. Arch Neurol. 1979; 36: 65-73.

16. Mohr JP. Lacunes. Stroke. 1982; 13(1): 3-11.

17. Amin OSM, Zangana HM, Ameen NA. The striatocapsular infarction and its aftermaths. BMJ. Case Reports. 2010; 10. 1136/bcr. 02.2010.2703.

18. Donnan GA, Bladin PF, Berkovic SF, Longley WA, Saling MM. The stroke syndrome of striatocapsular infarction. Brain. 1991; 114(Pt 1A): 51-70.

19. Jung S, Hwang SH, Lee BC. Distinct clinical expressions of striatocapsular infarction according to cortical manifestations. Eur J Neurol. 2004; 11(9): 627-633.

20. Weiller C, Ringelstein EB, Reiche W, Thron A, Buell U. The large striatocapsular infarct. A clinical and pathophysiological entity. Arch Neurol. 1990; 47(10): 1085-1091.

21. Russmann H, Vingerhoets F, Ghika J, Maeder P, Bogousslavsky J. Acute infarction limited to the lenticular nucleus: clinical, etiologic, and topographic features. Arch Neurol. 2003; 60(3): 351-355.

22. Bejot Y, Catteau A, Caillier M, Rouaud O, Durier J, Marie C, et al. Trends in incidence, risk factors, and survival in symptomatic lacunar stroke in Dijon, France, from 1989 to 2006: a population-based study. Stroke. 2008; 39(7): 1945-1951.

23. Jackson C, Sudlow C. Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts. Stroke. 2005; 36(4): 891-901.

24. Nicolai A, Lazzarino LG, Biasutti E. Large striatocapsular infarcts: clinical features and risk factors. J Neurol. 1996; 243(1): 44-450.

25. Mega MS, Alexander MP. Subcortical aphasia: the core profile of capsulostriatal infarction. Neurology. 1994; 44(10): 1824-1829.

26. Nadeau SE, Crosson B. Subcortical aphasia. Brain Lang. 1997; 58(3): 355-402; discussion: 418-23.

27. Bhatia KP, Marsden CD. The behavioural and motor consequences of focal lesions of the basal ganglia in man. Brain. 1994; 117(Pt 4): 859-876.

28. Edmans JA, Lincoln NB. The frequency of perceptual deficits after stroke. Clin Rehabil. 1987; 1: 273-281.

29. Stone SP, Halligan PW, Greenwood RJ. The incidence of neglect phenomenon and related disorders in patients with an acute right or left hemispherical stroke. Age Ageing. 1993; 22: 46-52

30. Kalra L, Perez I, Gupta S, Wittink M. The influence of visual neglect on stroke rehabilitation. Stroke. 1997; 28(7): 1386-1391.

31. Ween JE, Alexander MP, D’Esposito M, Roberts M. Factors predictive of stroke outcome in a rehabilitation setting. Neurology. 1996; 47(2): 388-392.

32. Marsden CD, Obeso JA, Zarranz JJ, Lang AE. The anatomical basis of symptomatic hemidystonia. Brain. 1985; 108(Pt 2): 463-483.

33. Giroud M, Lemesle M, Madinier G, Billiar T, Dumas R. Unilateral lenticular infarcts: radiological and clinical syndromes, aetiology, and prognosis. J Neurol Neurosurg Psychiatry. 1997; 63(5): 611-615.

34. Amin OSM, Shwani SS, Zangana HM, Ameen NA. Bilateral infarction of corpus striatum in a young woman: a case report and review of the literature. J Med Case Reports. 2011; 5: 324.

Be the first to comment

Leave a Reply

Your email address will not be published.


Ova web-stranica koristi Akismet za zaštitu protiv spama. Saznajte kako se obrađuju podaci komentara.