[Anterior choroidal artery syndromes]

Three cases of anterior choroidal artery territorial infarction, diagnosed by computerized tomography, with the triad of hemiplegia, hemianaesthesia and hemianopia, pure motor stroke and ataxic hemiparesis are described. Major and minor (lacular) infarctions in the territory of the anterior choroidal artery involve almost exclusively the basal segment of the posterior limb of the internal capsule and manifest themselves by symptoms of long pathway lesion. Based on the published case reports and the authors' own observations, the complete capsular syndrome characterized by the triad of hemiplegia, hemianaesthesia and hemianopia was differentiated from partial capsular syndromes including the following forms: pure motor stroke, pure sensory stroke, sensorimotor stroke, sensory stroke with hemiataxia, ataxic hemiparesis, dysarthria and/or clumsy hand, and homonymous hemianopia (quadrantanopia or sectoranopia). The characteristic features of the above types of capsular syndromes were analyzed. Distant symptoms of territorial infarctions involving the anterior choroidal artery are transcortical sensory or motor aphasias and construction apraxia in the dominant hemisphere, left side perception failure and visual-construction apraxia in the non-dominant hemisphere, and cerebellar hemiataxia. These distant symptoms are a manifestation of distant cortical or cerebellar metabolic depression due to the mechanism of diaschisis.