Chapter 34 - Caudate nucleus infarcts and hemorrhages

Summary

The basal ganglia (BG) including the caudate nucleus are well known for their motor functions. The BG nuclei are anatomically and functionally associated with each of the frontal-striatal-thalamic-frontal circuits or loops. The caudate nucleus assumes the shape of a comet, curving along the lateral wall of the lateral ventricle. The caudate nucleus receives its blood supply mainly through the deep penetrators arising from the anterior cerebral arteries (ACAs) and middle cerebral arteries (MCAs) although there are individual differences. The major risk factors for caudate nucleus infarcts are: hypertension, hypercholesterolemia, diabetes mellitus, previous myocardial infarct, and cigarette smoking. As caudate nucleus infarcts can develop from any stroke mechanisms including lipohyalinosis, branch atheromatous disease, large artery atherothrombosis, or embolism, treatment of patients with caudate nucleus infarcts depends on the underlying stroke mechanism. Caudate nucleus hemorrhages account for approximately 7% of all intracerebral hemorrhages (ICH) and are caused by rupture of penetrating arteries.