Anterior choroidal artery syndrome

Anterior choroidal artery syndrome is a rare entity characterized by the triad of

• hemiplegia
• hemianaesthesia and
• contralateral hemianopia

This occurs as a result of cerebral infarction in the anterior choroidal artery territory.

The syndrome may also be associated with neuropsychological disorders, including left neglect syndrome in right-sided lesions and disorders of speech in left-sided lesions.

Incomplete forms of the syndrome are more common than that of complete forms.  The incomplete forms include lacunar syndromes and ataxic hemiparesis ⁵.

Etiology

The complete anterior choroidal artery strokes are usually associated with cardioembolic sources and carotid stenosis. Smaller strokes that involve only parts of the territory are typically due to T2 diabetes mellitus, hypertension and hyperlipidemia ⁵. The triad of symptoms is rare to see because of the anastomosis with perforators from the middle cerebral, posterior cerebral and posterior communicating arteries.

Diagnosis

The anterior choroidal artery has an extensive area of supply and large variations in its distributed territory ⁶. As a result of its extensive and strategic supply, anterior choroidal artery infarcts can often be confused with posterior cerebral artery or middle cerebral infarcts ⁶.