Anterior choroidal artery infarct

Case contributed by Dr Dalia Ibrahim


Sudden onset of right sided hemiplegia and hemi hypoesthesia.

Patient Data

Age: 75-year-old
Gender: Male

Abnormal signal and diffusion restriction are involving the left hippocampus and posterior limb of left internal capsuleain keeping with "acute infarction along the left anterior choroidal artery distribution".

Loss of signal void of the intracranial portion (namely its petrous, cavernous and supraclinoid segments) of the left internal carotid artery (likely occluded).

Small artery disease.

Brain atrophic changes.


Case Discussion

Anterior choroidal artery infarction secondary to occluded left internal carotid artery.

The anterior choroidal artery originates from the posterior wall of the internal carotid artery between the origin of posterior communicating artery (PCOM) and the internal carotid termination. It may also arise from the middle cerebral artery (MCA).

 Vascular territory

  • hippocampus and amagydala
  • posterior limb of the internal capsule
  • optic tract
  • lateral geniculate nucleus and lateral aspect of thalamus
  • lateral aspect of the midbrain
  • choroid plexus of the anterior part of the temporal horns of the lateral ventricles

AChA syndrome 1

  • consists of contralateral hemiplegia, contralateral hemi hypoesthesia, and homonymous hemianopsia,
    • Hemi plegia/paresis secondary to posterior limb of the internal capsule involvement.
    • Hemi hypoesthesia/loss ventral postero lateral nucleus of the thalamus involvement.
    • Hemianopsia secondary to lateral geniculate body involvement.
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Case information

rID: 42808
Published: 9th Feb 2016
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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