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Anterior Choroidal Artery-Territory Infarction: Report of Cases and Review

Anterior Choroidal Artery-Territory Infarction: Report of Cases and Review Abstract • Occlusion of the anterior choroidal artery (AChA) can cause infarction in the posterior limb of the internal capsule. Infarction is less frequent in the thalamus, midbrain, temporal lobe, and lateral geniculate body territories of the AChA. The most common clinical sign is hemiparesis. Hemisensory loss is usually transient but may be severe at onset. Homonymous upper-quadrant anopia, hemianopia, or upper- and lower-quadrant sector anopsia can be present. A homonymous defect in the upper and lower visual fields sparing the horizontal meridian is probably diagnostic of a lesion in the lateral geniculate body in the territory of the AChA. The most common stroke mechanism is small-vessel occlusive disease, predominantly found in hypertensive and diabetic patients, but cardiacorigin embolism also can affect the AChA territory. Two of our patients had infarction after temporal lobe resection for epilepsy. Occasionally patients have associated disabilities of higher cortical function that are usually transient. The lesion should be recognizable by computed tomography. References 1. Foix C, Chavany H, Hillemand P, et al: Obliteration de l'artére choroidienne anterieure: Ramollissement cerebral hemiplegie, hemianesthesie et hemianopsie . Soc Ophtalmol 1925;27:221-223. 2. Abbie A: The clinical significance of the anterior choroidal artery . Brain 1933;56:233-246.Crossref 3. Abbie A: The blood supply of the lateral geniculate body with a note on the morphology of the choroidal arteries . J Anat 1933;67:491-527. 4. Poppi U: Sindrome talamo capsulare per ramollimento nel territorio dell'arteria coroidea anteriore . Riv Patol Nerv Ment 1928;33:505-542. 5. Ley J: Contribution à l'étude de ramollissement cerebral, envisagée au point du vue de la pathogenie de l'ictus apoplectique . J Neurol Psychiatr 1932;32:785-970. 6. Steegman A, Roberts D: The syndrome of the anterior choroidal artery: Report of a case . JAMA 1935;104:1695-1697.Crossref 7. Pertuiset B, Aron D, Dilenge D, et al: Les syndromes de l'artère choroidinne anterieure: Etude clinique and radiologique . Rev Neurol 1962;106:286-294. 8. Cooper I: Surgical occlusion of the anterior choroidal artery in parkinsonism . Surg Gynecol Obstet 1955;99:207-219. 9. DuBois-Poulson A, Guillaume J, Magis C: La ligature de l'artère choroidienne anterieure . Bull Mem Soc Fr Ophtalmol 1956;69:450-465. 10. Rand R, Brown W, Stern E: Surgical occlusion of anterior choroidal arteries in parkinsonism: Clinical and neuropathological findings . Neurology 1956;6:390-401.Crossref 11. Morillo A, Cooper I: Occlusion of the anterior choroidal artery . Am J Ophthalmol 1955;40:796-801. 12. Buge A, Escourolle R, Hauw J, et al: Syndrome pseudobulbaire aigu par infarctus bilateral limité du territoire des artères choroidiennes anterieures . Rev Neurol 1979;135:313-318. 13. Cambier J, Graveleau P, DeCroix J, et al: Le syndrome de l'artère choroidienne anterieure: Etude neuropsychologique de 4 cas . Rev Neurol 1983;139:553-559. 14. Masson M, DeCroix J, Henin D, et al: Syndrome de l'artère choroidienne anterieure: Etude clinique et tomodensitometrique de 4 cas . Rev Neurol 1983;139:547-552. 15. Viader F, Masson M, Marion M, et al: Infarctus cerebral dans le territoire de l'artère choroidienne anterieure avec troubles oculomoteur . Rev Neurol 1984;140:668-670. 16. Ward T, Bernat J, Goldstein A: Occlusion of the anterior choroidal artery . J Neurol Neurosurg Psychiatry 1984;47:1048-1049.Crossref 17. Rhoton A, Kiyotaka F, Fradd B: Microsurgical anatomy of the anterior choroidal artery . Surg Neurol 1979;12:171-187. 18. Herman L, Fernando O, Gurdjian E: The anterior choroidal artery: An anatomical study of its area of distribution . Anat Rec 1966;154:95-102.Crossref 19. Stephens R, Stilwell D: Arteries and Veins of the Human Brain . Springfield, Ill, Charles C Thomas Publishers, 1969. 20. Percheron G: Les artères du thalamus humain: Les arteres choroidiennes . Rev Neurol 1977;133:547-548. 21. Yasargil M, Yonas H, Gasser J: Anterior choroidal artery aneurysms: Their anatomy and surgical significance . Surg Neurol 1978;9:129-138. 22. Rascol A, Clanet M, Manelfe C, et al: Pure motor hemiplegia: CT study of 30 cases . Stroke 1982;13:11-17.Crossref 23. Falconer M, Wilson J: Visual field changes following anterior temporal lobectomy: Their insignificance in relation to 'Meyers loop' of the optic radiation . Brain 1958;81:1-14.Crossref 24. Jensen I: Temporal lobe surgery around the world: Results, complications and mortality . Acta Neurol Scand 1975;52:354-373.Crossref 25. Penfield W, Lende R, Rasmussen T: Manipulation hemiplegia: An untoward complication in the surgery of focal epilepsy . J Neurosurg 1961;18:760-776.Crossref 26. Derouesne C, Yelnik A, Castaigne P: Deficit sensitif isole par infarctus dans le territoire de l'artère choroidienne anterieure . Rev Neurol 1985;141:311-314. 27. Graff-Radford N, Damasio H, Yamada T, et al: Non-hemorrhagic thalamic infarction . Brain 1985;108:485-516.Crossref 28. Frisen L, Holmegaard L, Rosencrantz M: Sectorial optic atrophy and homonymous, horizontal sectoranopia: A lateral choroidal artery syndrome . J Neurol Neurosurg Psychiatry 1978;41:374-380.Crossref 29. Frisen L: Quadruple sectoranopia and sectorial optic atrophy: A syndrome of the distal anterior choroidal artery . J Neurol Neurosurg Psychiatry 1979;42:590-594.Crossref 30. Hommel M, DuBois F, Pollak P, et al: Syndrome de l'artère choroidienne anterieure ganche avec troubles du language et apraxie constructive . Rev Neurol 1985;141:137-142. 31. Damasio H: A computed tomographic guide to the identification of cerebral vascular territories . Arch Neurol 1983;40:138-142.Crossref 32. Takahashi S, Kawata Y, Uemura K: CT findings in anterior choroidal artery occlusion . Rinsho Hoshasen 1980;25:575-581. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Anterior Choroidal Artery-Territory Infarction: Report of Cases and Review

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Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1986.00520070039015
Publisher site
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Abstract

Abstract • Occlusion of the anterior choroidal artery (AChA) can cause infarction in the posterior limb of the internal capsule. Infarction is less frequent in the thalamus, midbrain, temporal lobe, and lateral geniculate body territories of the AChA. The most common clinical sign is hemiparesis. Hemisensory loss is usually transient but may be severe at onset. Homonymous upper-quadrant anopia, hemianopia, or upper- and lower-quadrant sector anopsia can be present. A homonymous defect in the upper and lower visual fields sparing the horizontal meridian is probably diagnostic of a lesion in the lateral geniculate body in the territory of the AChA. The most common stroke mechanism is small-vessel occlusive disease, predominantly found in hypertensive and diabetic patients, but cardiacorigin embolism also can affect the AChA territory. Two of our patients had infarction after temporal lobe resection for epilepsy. Occasionally patients have associated disabilities of higher cortical function that are usually transient. The lesion should be recognizable by computed tomography. References 1. Foix C, Chavany H, Hillemand P, et al: Obliteration de l'artére choroidienne anterieure: Ramollissement cerebral hemiplegie, hemianesthesie et hemianopsie . Soc Ophtalmol 1925;27:221-223. 2. Abbie A: The clinical significance of the anterior choroidal artery . Brain 1933;56:233-246.Crossref 3. Abbie A: The blood supply of the lateral geniculate body with a note on the morphology of the choroidal arteries . J Anat 1933;67:491-527. 4. Poppi U: Sindrome talamo capsulare per ramollimento nel territorio dell'arteria coroidea anteriore . Riv Patol Nerv Ment 1928;33:505-542. 5. Ley J: Contribution à l'étude de ramollissement cerebral, envisagée au point du vue de la pathogenie de l'ictus apoplectique . J Neurol Psychiatr 1932;32:785-970. 6. Steegman A, Roberts D: The syndrome of the anterior choroidal artery: Report of a case . JAMA 1935;104:1695-1697.Crossref 7. Pertuiset B, Aron D, Dilenge D, et al: Les syndromes de l'artère choroidinne anterieure: Etude clinique and radiologique . Rev Neurol 1962;106:286-294. 8. Cooper I: Surgical occlusion of the anterior choroidal artery in parkinsonism . Surg Gynecol Obstet 1955;99:207-219. 9. DuBois-Poulson A, Guillaume J, Magis C: La ligature de l'artère choroidienne anterieure . Bull Mem Soc Fr Ophtalmol 1956;69:450-465. 10. Rand R, Brown W, Stern E: Surgical occlusion of anterior choroidal arteries in parkinsonism: Clinical and neuropathological findings . Neurology 1956;6:390-401.Crossref 11. Morillo A, Cooper I: Occlusion of the anterior choroidal artery . Am J Ophthalmol 1955;40:796-801. 12. Buge A, Escourolle R, Hauw J, et al: Syndrome pseudobulbaire aigu par infarctus bilateral limité du territoire des artères choroidiennes anterieures . Rev Neurol 1979;135:313-318. 13. Cambier J, Graveleau P, DeCroix J, et al: Le syndrome de l'artère choroidienne anterieure: Etude neuropsychologique de 4 cas . Rev Neurol 1983;139:553-559. 14. Masson M, DeCroix J, Henin D, et al: Syndrome de l'artère choroidienne anterieure: Etude clinique et tomodensitometrique de 4 cas . Rev Neurol 1983;139:547-552. 15. Viader F, Masson M, Marion M, et al: Infarctus cerebral dans le territoire de l'artère choroidienne anterieure avec troubles oculomoteur . Rev Neurol 1984;140:668-670. 16. Ward T, Bernat J, Goldstein A: Occlusion of the anterior choroidal artery . J Neurol Neurosurg Psychiatry 1984;47:1048-1049.Crossref 17. Rhoton A, Kiyotaka F, Fradd B: Microsurgical anatomy of the anterior choroidal artery . Surg Neurol 1979;12:171-187. 18. Herman L, Fernando O, Gurdjian E: The anterior choroidal artery: An anatomical study of its area of distribution . Anat Rec 1966;154:95-102.Crossref 19. Stephens R, Stilwell D: Arteries and Veins of the Human Brain . Springfield, Ill, Charles C Thomas Publishers, 1969. 20. Percheron G: Les artères du thalamus humain: Les arteres choroidiennes . Rev Neurol 1977;133:547-548. 21. Yasargil M, Yonas H, Gasser J: Anterior choroidal artery aneurysms: Their anatomy and surgical significance . Surg Neurol 1978;9:129-138. 22. Rascol A, Clanet M, Manelfe C, et al: Pure motor hemiplegia: CT study of 30 cases . Stroke 1982;13:11-17.Crossref 23. Falconer M, Wilson J: Visual field changes following anterior temporal lobectomy: Their insignificance in relation to 'Meyers loop' of the optic radiation . Brain 1958;81:1-14.Crossref 24. Jensen I: Temporal lobe surgery around the world: Results, complications and mortality . Acta Neurol Scand 1975;52:354-373.Crossref 25. Penfield W, Lende R, Rasmussen T: Manipulation hemiplegia: An untoward complication in the surgery of focal epilepsy . J Neurosurg 1961;18:760-776.Crossref 26. Derouesne C, Yelnik A, Castaigne P: Deficit sensitif isole par infarctus dans le territoire de l'artère choroidienne anterieure . Rev Neurol 1985;141:311-314. 27. Graff-Radford N, Damasio H, Yamada T, et al: Non-hemorrhagic thalamic infarction . Brain 1985;108:485-516.Crossref 28. Frisen L, Holmegaard L, Rosencrantz M: Sectorial optic atrophy and homonymous, horizontal sectoranopia: A lateral choroidal artery syndrome . J Neurol Neurosurg Psychiatry 1978;41:374-380.Crossref 29. Frisen L: Quadruple sectoranopia and sectorial optic atrophy: A syndrome of the distal anterior choroidal artery . J Neurol Neurosurg Psychiatry 1979;42:590-594.Crossref 30. Hommel M, DuBois F, Pollak P, et al: Syndrome de l'artère choroidienne anterieure ganche avec troubles du language et apraxie constructive . Rev Neurol 1985;141:137-142. 31. Damasio H: A computed tomographic guide to the identification of cerebral vascular territories . Arch Neurol 1983;40:138-142.Crossref 32. Takahashi S, Kawata Y, Uemura K: CT findings in anterior choroidal artery occlusion . Rinsho Hoshasen 1980;25:575-581.

Journal

Archives of NeurologyAmerican Medical Association

Published: Jul 1, 1986

References