Partial anterior circulation infarct

Partial Anterior Circulation Infarct (PACI) is a type of ischemic stroke that occurs when the blood supply to part of the anterior circulation of the brain is reduced or interrupted. The anterior circulation is supplied by the internal carotid arteries, which branch into the middle cerebral artery (MCA) and the anterior cerebral artery (ACA). PACI typically involves areas of the brain supplied by these arteries, which can affect the frontal, parietal, and temporal lobes, leading to a variety of neurological deficits.

Causes

PACI is most commonly caused by atherosclerosis, where plaque buildup narrows the arteries, reducing blood flow. Other causes include cardiac embolism, where a clot formed in the heart travels to the brain, and small vessel disease, affecting the brain's smaller arterial vessels. Risk factors mirror those of other types of stroke, including hypertension, diabetes mellitus, smoking, and atrial fibrillation.

Symptoms

Symptoms of PACI can vary widely depending on the specific brain areas affected but generally include weakness or paralysis on one side of the body (hemiparesis), difficulty speaking or understanding language (aphasia), and visual disturbances. Patients may also experience confusion, difficulty with coordination and balance, and severe headaches.

Diagnosis

Diagnosis of PACI involves a combination of clinical assessment and imaging techniques. Magnetic resonance imaging (MRI) or computed tomography (CT) scans are used to visualize the brain and identify areas of infarction. Additional tests, such as carotid ultrasound, echocardiography, and blood tests, are performed to determine the underlying cause of the stroke.

Treatment

Treatment for PACI aims to restore blood flow to the affected area of the brain as quickly as possible. This may involve the use of clot-busting drugs (thrombolysis), mechanical removal of the clot (thrombectomy), or procedures to prevent further clot formation (anticoagulation therapy). Rehabilitation, including physical, occupational, and speech therapy, is crucial for recovery and maximizing the patient's functional abilities.

Prognosis

The prognosis for individuals with PACI varies. Factors influencing recovery include the size and location of the infarct, the patient's overall health, and the timeliness of treatment initiation. While some patients may experience significant recovery, others may have lasting disabilities.

Prevention

Prevention of PACI involves managing risk factors for stroke. This includes controlling blood pressure, managing diabetes, quitting smoking, maintaining a healthy weight, and regular exercise. In some cases, medications to reduce blood clot risk or surgery to remove plaque buildup in the arteries may be recommended.