Posterior choroidal artery stroke

Last revised by Craig Hacking on 27 Jul 2022

Posterior choroidal artery occlusion uncommonly presents as an isolated stroke syndrome.  It usually coexists with posterior cerebral artery and often superior cerebellar artery involvement. 

When seen in isolation damage is characteristically limited to the:

  • lateral geniculate body
  • pulvinar
  • posterior thalamus
  • hippocampus
  • parahippocampal gyrus

When infarction is limited to to the lateral posterior choroidal artery territory, the most common clinical manifestations include:

  • homonymous quadrantanopsia +/- hemisensory loss
  • neuropsychological dysfunction (trans-cortical aphasia, memory disturbances).
  • homonymous horizontal sector anopsia (uncommon but highly suggestive of the involvement of the lateral geniculate body)

Medial posterior choroidal artery territory infarction is less frequent with Its neurologic presentation dominated by eye movement disorders.

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