Territorial strokes as a tool to learn vascular territories

Abstract

Stroke is the fourth leading cause of death in the United States and a leading cause of serious, long-term adult disability. One of the key tasks in establishing the diagnosis of acute ischemic stroke and determining its appropriate treatment is establishing the arterial territory affected. Knowledge of cerebral vascular territories helps identify abnormal vessels on CT and conventional angiograms, confirms that a DWI hyperintense lesion represents an acute arterial stroke, and guides further investigations and treatment. Factors contributing to understanding vascular territories include the anatomy of the intracranial circulation and its normal variants and the intrinsic variability in the extent of brain supplied by the main branches of the intracranial circulation. This chapter reviews the normal anatomy of intracranial arteries and describes the vascular distribution as seen on CT and MRI using major territorial strokes as a learning tool.