To explore the clinical characteristics of single subcortical cerebral infarction of middle cerebral artery (MCA) territory and the possible pathogenesis.

A total of 344 cases diagnosed as single subcortical cerebral infarction of MCA territory were enrolled in the study and divided into the parent artery disease (PAD) group and the non-PAD group according to whether the MCA stenosis was presented or not. A total of 312 cases diagnosed as single subcortical cerebral infarction of MCA territory were divided into the BAD group and the SVD group according to the relationship between the lesion sites and MCA. Differences in the clinical and imaging feature were compared between different groups.

A total of 32 patients were in the PAD group. Compared with the non-PAD group, patients in the PAD group were found with higher prevalence of asymptomatic cerebral arterial atherosclerosis [93.8%(30/32) vs 57.1%(178/312), P<0.001], higher prevalence of branch atheromatous disease[75.0%(24/32) vs 58.7%(183/312), P=0.072]. A total of 183 patients were in the BAD group. Compared with the BAD group, patients in the SVD group were older[(64.7±11.2) years vs (61.7±12.2) years, P=0.031], more with hypertension [65.9%(85/129) vs 53.0%(97/183), P=0.027] and smoking [41.9%(54/129) vs 57.9%(106/183), P=0.006] and more severe leukoaraiosis.

Single subcortical cerebral infarction of MCA territory has different etiology and pathogenesis. Evidence of systemic atherosclerosis should be carefully searched in patients with branch atheromatous disease.

Stroke; Middle cerebral artery; Branch atheromatous disease