Case Of the Week (COW) 16 Feb 2014
Answer:
Anterior Choroidal Artery Territory Infarct.
Findings:
FLAIR hyperintensities with low ADC values reflecting Acute infarct noted involving the right parahippocampal region , posterior limb of internal capsule and right posterior paraventricular corona radiata.
Discussion:
In 1925- Foix described this syndrome characterized by triad of hemiparesis, hemianaesthesia, and hemianopia. Anterior Choroidal artery is a Small artery – that originates in the posterior wall of the internal carotid, 2 to 5mm distal to the posteriorcommunicating artery (PCoA) and 2 to 5 mm proximal tothe intracranial carotid bifurcation in 96 -99.5% of cases. The infarct follows a typical distribution as described in this case. Another important feature of these infarcts is that these are rarely due to small vessel occlusion and warrant a complete diagnostic workup.
References:
Anterior choroidal artery territory infarcts. Study of presumed mechanisms.- D Leys Stroke. 1994;25:837-842
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology
Senior Consultant Radiologist, Aarthi Scans, Chennai
Answer:
Anterior Choroidal Artery Territory Infarct.
Findings:
FLAIR hyperintensities with low ADC values reflecting Acute infarct noted involving the right parahippocampal region , posterior limb of internal capsule and right posterior paraventricular corona radiata.
Discussion:
In 1925- Foix described this syndrome characterized by triad of hemiparesis, hemianaesthesia, and hemianopia. Anterior Choroidal artery is a Small artery – that originates in the posterior wall of the internal carotid, 2 to 5mm distal to the posteriorcommunicating artery (PCoA) and 2 to 5 mm proximal tothe intracranial carotid bifurcation in 96 -99.5% of cases. The infarct follows a typical distribution as described in this case. Another important feature of these infarcts is that these are rarely due to small vessel occlusion and warrant a complete diagnostic workup.
References:
Anterior choroidal artery territory infarcts. Study of presumed mechanisms.- D Leys Stroke. 1994;25:837-842
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology
Senior Consultant Radiologist, Aarthi Scans, Chennai