Infarction anterior

Aphasia and neglect can be found following respectively dominant and non-dominant anterior choroidal artery infarcts. Anterior choroidal artery infarcts usually cause the classical 3H syndrome hemiparesis, hemihypesthesia, hemianopia. Pure motor hemiparesis and isolated hemianopia can also occur (Han et al. 2000). Anterior choroidal artery territory infarcts are rarely caused by small vessel occlusion. In general they are caused by cardioembolism or large artery disease with occlusion or artery-to-artery embolism (Leys et al. 1994). 

It is important to obtain a baseline EKG and cardiac enzymes to evaluate the possibility of an acute myocardial infarction. The short-term (2-4 weeks) stroke risk after acute myocardial infarction (AMI) is 2.5%. Stroke is usually an early (within 14 days) complication of AMI and is more common in anterior wall (4—12%) than in inferior wall infarction (1%). Approximately 40% of patients with an anterior wall myocardial infarction develop left ventricular thrombus. 

Recommended if patient is at high-risk of systemic thromboembolism (anterior wall infarction, heart failure, left ventricular thrombus, atrial fibrillation, previous embolism)... 

STE ACS, class I recommendation within the first 24 hours after hospital presentation for patients with anterior wall infarction, clinical signs of heart failure and those with EF less than 40% in the absence of contraindications, class I la recommendation for all other patients in the absence of contraindications. 

Orotic acid or 6-methyluracil vide infra), when administered to rabbits with myocardial infarction induced by ligation of the anterior descending branch of the left coronary artery, can decrease the incidence of necrosis and increase the rate of regeneration for healthy cellular and fibrous connective tissue in the infarct region [182]. Rats with induced aortal stenosis which are treated with... 

Sugiura T, Iwasaka T, Hasegawa T, et al. Factors associated with persistent and transient fascicular blocks in anterior wall acute myocardial infarction. Am. J. Cardiol. 1989 63 784-7. 

The biodistribution of intravenously injected allogeneic MSCs has been recently described [131]. Oxine-labeled MSCs were injected intravenously 72 h after occlusion/reperfusion in seven dogs. Initially, cells were trapped in the lungs within 24 h after injection, they had been redistributed into the liver and spleen. Focal uptake and persistence of the stem cells was observed in a mid anterior wall location corresponding to the infarcted target area. 

A day after a dose of intravenous methylprednisolone 60 mg a 79-year-old woman developed acute thoracic pain and collapsed. An electrocardiogram showed signs of a myocardial infarction and her cardiac enzyme activities were raised. She died within several hours. Autopsy showed an anterior transmural myocardial infarction and mild atheromatous lesions in the coronary arteries. 

Abbreviations AMI, acute myocardial infarction LAD, left anterior descending LCX, left circumflex LMCA, left main coronary artery RCA, right coronary artery pt, patient. 

Lunde KSS, Aakhus S, Arnesen H, Forfang K. Intracoronary injections of autologous mononuclear bone marrow cells in acute anterior wall myocardial infarction the ASTAMI randomized controlled trial, In Scientific Sessions of the American Heart Association 2005, Internet communication, 2006,... 

Kuethe F Richartz BM, Sayer HG, et al. Lack of regeneration of myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans with large anterior myocardial infarctions, Int J Cardiol 2004 97 123-127. 

Possible complications include massive myocardial infarction due to retrograde flow around the occlusion balloon, complete heart block, ventricular fibrillation, stroke, dissection of the left anterior descending artery, and right coronary artery thrombosis. Though high grade atrioventricular blockage occurs relatively frequently, procedural mortality rate is low (0-4%) and severe complications are rare and often avoidable (7-10). 

Blockade of the anterior choroidal artery may cause infarction of the lateral geniculate body causing hemianopia with preserved central vision and a prominent sensory loss with hemiparesis (Bruno et al. 1989). 

Amarenco P, Hauw JJ (1990) Cerebellar infarction in the territory of the anterior and inferior cerebellar artery. A clinico-pathological study of 20 cases. Brain 113 139-155 Baquis GD, Pessin MS, Scott RM (1985) Limb shaking - a carotid TIA. Stroke 16 444-448 Barth A, Bogousslavsky J, Regli F (1994) Infarcts in the territory of the lateral branch of the posterior inferior cerebellar artery. J Neurol Neurosurg Psychiatry 57 1073-1076 Baumgartner RW, Sidler C, Mosso M et al (2003) Ischemic lacunar stroke in patients with and without potential mechanism other than small-artery disease. Stroke 34 653-659... 

Brazis PW, Masdeu JC, Biller J (1990) Localization in clinical neurology, 3rd edn. Little Brown, Boston Bruno A, Graff-Radford NR, Biller J et al (1989) Anterior choroidal artery territory infarction a small vessel disease. Stroke 20 616-619... 

---