Three-Dimensional Maps of the Lenticulostriate Artery Territory.

Abstract

Accurate knowledge of the cerebral vascular territories is foundational to stroke care. Yet, precise digital reference maps are not widely accessible, especially for subcortical structures. To address this shortcoming, we constructed 3-dimensional vascular territory maps of the MCA perforators-the lenticulostriate arteries (LSAs). Nineteen LSA infarcts were demarcated on DWI scans and then normalized onto a standard 3-dimensional template brain. Normalized infarct volumes were then superimposed to create infarct density maps (heatmaps). LSA territory heatmaps display the spatial distribution of infarct frequency of the entire territory and highlight its spatially consistent subterritories: medial group, lateral group-<i>rostral</i>, and lateral group-<i>caudal</i>. The maps show each territory's most commonly affected core, as well as their typical shape, boundary, and variability. The LSA territory maps can be used for education, clinical reference, or research. They can be explored 3-dimensionally on any web browser or downloaded for use. In addition, we present a framework for understanding infarcts within the LSA system based on microvascular architecture.