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Mariam Mahmoud Ali: Understanding Vascular Territories Is Key to Quickly Localizing Strokes on MRI
Mar 28, 2026, 16:07

Mariam Mahmoud Ali: Understanding Vascular Territories Is Key to Quickly Localizing Strokes on MRI

Mariam Mahmoud Ali, Neurology Resident at Shifa Hospitals Group, shared on LinkedIn:

”Anterior Circulation Stroke Patterns on MRI (DWI)

Understanding vascular territories is key to quickly localizing strokes on MRI.

The anterior circulation – primarily supplied by the internal carotid artery – feeds most of the frontal, parietal, and temporal lobes.

Each arterial occlusion produces a characteristic infarct pattern:

Carotid T-Occlusion

  • Massive infarction (ACA plus MCA territories)
  • Severe neurological deficit

ACA Occlusion

  • Medial frontal/parietal infarct
  • Leg weakness, behavioral changes, incontinence

MCA M1 Occlusion

  • Large cortical infarct (frontal, parietal, temporal)
  • Hemiplegia, aphasia, visual field loss

MCA M2 Occlusion

  • More localized cortical infarct
  • Focal deficits (language/sensory/motor depending on branch)

Lenticulostriate Infarction

  • Deep structures (basal ganglia, internal capsule)
  • Often due to hypertension

Striatocapsular Infarction

  • Large deep infarct
  • Severe motor deficits

Key Radiology Tip:
On DWI – Acute infarcts appear bright equals early detection plus precise localization.”

Mariam Mahmoud Ali: Understanding Vascular Territories Is Key to Quickly Localizing Strokes on MRI

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