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This artery, through its cortical branches, supplies the anterior three-quarters of the medial surface of the frontal lobe, including its medial-orbital surface, the frontal pole, a strip of the lateral surface of the cerebral hemisphere along the superior border, and the anterior four- fths of the corpus callosum Deep branches, arising near the circle of Willis (proximal or distal to the anterior communicating artery), supply the anterior limb of the internal capsule, the inferior part of the head of the caudate nucleus, and the anterior part of the globus pallidus (Figs 34-5, 34-6, and 34-7) The largest of these deep branches is the artery of Heubner The clinical picture will depend on the location and size of the infarct, which, in turn, relates to the site of the occlusion, the pattern of the circle of Willis, and the other ischemia-modifying factors mentioned earlier Well-studied cases of infarction in the territory of the anterior cerebral artery are not numerous; hence the syndromes have not been completely elucidated (see Brust and also Bogousslavsky and Regli for a review of the literature and a description of developmental abnormalities of the artery) Occlusion of the stem of the anterior cerebral artery, proximal to its connection with the anterior communicating artery (the A1 segment, in neuroradiologic parlance), is usually well tolerated, since adequate collateral ow will come from the artery of the opposite side Maximal disturbance occurs when both arteries arise from one anterior cerebral stem, in which case occlusion of the stem will cause infarction of the anterior and medial parts of both cerebral hemispheres and result in paraplegia, incontinence, abulia and motor aphasic symptoms, and frontal lobe personality changes (Chap 22) Occlusion of the anterior cerebral arteries is usually embolic, but atherothrombotic lesions are known and surgical instances have been described (occlusion with operations on anterior communicating aneurysms) Complete infarction due to occlusion of one anterior cerebral artery distal to the anterior communicating artery (A2 segment) results in a sensorimotor de cit of the opposite foot and leg and, to a lesser degree, of the shoulder and arm, with sparing of the hand and face The motor disorder is more pronounced in the foot and leg than in the hip and thigh Sensory loss, when it occurs, is mainly of the discriminative modalities and is mild or absent in some cases The head and eyes may deviate to the side of the lesion Urinary incontinence and a contralateral grasp re ex and paratonic.

This dashboard uses all the different concepts and rules described in the previous chapters: The title of the dashboard is very straightforward Annual Sales by Region vs Top Competitors All the information fits on one screen, so the business user doesn t have to scroll to see additional information Although we do have additional information included in this format such as future sales growth, we don t have to navigate around the screen to display We can review the current actuals, then navigate to or execute a what-if analysis directly from the present screen

date infarctions, a syndrome of inattentiveness, abulia, forgetfulness, and sometimes agitation and psychosis was observed Transitory choreoathetosis and other dyskinesias have also been attributed to ischemia of basal ganglia, occurring sometimes under conditions of prolonged standing and exercise (Caplan and Sergay; Margolin and Marsden)

Figure 34-7 Corrosion preparations with plastics demonstrating penetrating branches of the anterior and middle cerebral arteries (1) Lateral lenticulostriate arteries (2) Heubner artery and medial lenticulostriate arteries (3) Anterior cerebral artery (4) Internal carotid artery (5) Middle cerebral artery (Reproduced by permission from Krayenbuhl and Yasargil)

rigidity (gegenhalten) may be evident With a left-sided occlusion, there may be a sympathetic apraxia of the left arm and leg or involuntary misdirected movements of the left arm (alien arm or hand) Also, transcortical motor aphasia (page 423) may occur with occlusions of Heubner s branch of the left anterior cerebral artery Alexander and Schmitt cite cases in which a right hemiplegia (predominant in the leg) with grasping and groping responses of the right hand and buccofacial apraxia are accompanied by a diminution or absence of spontaneous speech, agraphia, labored telegraphic speech, and a limited ability to name objects and compose word lists but with a striking preservation of the ability to repeat spoken and written sentences (ie, transcortical motor aphasia) Disorders of behavior that may be overlooked are abulia, presenting as slowness and lack of spontaneity in all reactions, muteness or a tendency to speak in whispers, and distractibility Branch occlusions of the anterior cerebral artery produce only fragments of the total syndrome, usually a spastic weakness or corticosensory loss in the opposite foot and leg With occlusion of penetrating branches of the anterior cerebral artery on one or both sides, the anterior limb of the internal capsule and caudate are usually involved In a series of 18 cases of unilateral caudate region infarcts collected by Caplan and associates, a transient hemiparesis was present in 13 Dysarthria and either abulia or agitation and hyperactivity were also common Stuttering and language dif culty occurred with two of the leftsided lesions and visuospatial neglect with three of the right-sided ones To what extent these symptoms were due to a disturbance of neighboring structures is dif cult to determine With bilateral cau-

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Very direct chart types enhancements are used The dynamic component of this is that we can really see the difference in the coloring and highlighting that are available in this dashboard The chart at the bottom right has a very interesting approach to showing the current actual sales versus the forecast sales The same information is displayed using two different chart types in the same chart It actually works in this case and shows a dramatic difference between the actual data and the forecasted data This uses the concept that we talked about to draw the business users, attention to the critical KPI first before viewing the remaining information All in all, this is a very direct, easy-to-read set of KPIs being displayed as a dashboard The one additional function that is available using Xcelsius but not available with the WAD is the ability to move the what-if slider control to adjust the projected sales growth and see the information onscreen automatically adjust to the change With the WAD and even the VC there is some functionality to allow us to execute this type of what-if analysis, but compared to the functionality available in the BOBJ components, these options are only about 75% of the level of interaction and this requires additional effort by the BI IT team to configure In Xcelsius the functionality is standard for this component You can see in the following illustration, the projected sales growth has been adjusted to 1050%, with a corresponding shift of all the indicators