10/04/2026
🧠⚡ Types of ICA Infarct – Can You Identify Them All?
The Internal Carotid Artery (ICA) plays a crucial role in cerebral perfusion, and its occlusion can present with diverse infarct patterns on DWI MRI. Recognizing these patterns is key for accurate diagnosis and timely management.
🔍 Key Patterns to Know:
🟦 Territorial Infarct – Large wedge-shaped cortical involvement (MCA/ACA territory) → severe neurological deficits
🟩 Subcortical Infarct – Deep structures (basal ganglia/internal capsule) → small focal lesions
🟨 Large Territorial Infarct – Combined cortical + subcortical → suggests proximal ICA occlusion ⚠️
🟥 Cortical Infarct – Peripheral scattered lesions → often embolic origin
🌊 Watershed Infarcts (Hypoperfusion clues):
🟪 Internal – “String of pearls” appearance (severe ICA stenosis)
🟧 Posterior – MCA–PCA border zone (visual symptoms 👁️)
🟩 Anterior – ACA–MCA border zone (proximal limb weakness 💪)
🟦 Deep – Periventricular linear lesions
Important Clinical Tip for Radiology Professionals:
👉 Multiple watershed infarcts = Think ICA stenosis / systemic hypotension
👉 Large territorial infarct = Think proximal ICA or MCA occlusion
💡 Radiologist Insight:
Always correlate DWI findings with vascular imaging (CTA/MRA) to identify the level of occlusion and guide urgent stroke management. Time = Brain
📌 Save this post & test your knowledge!
💬 Comment below: Which infarct pattern is most commonly embolic?
🧠