Related Experiment Videos
Anterior choroidal artery territory infarction: a small vessel disease
A Bruno1, N R Graff-Radford, J Biller
1Department of Neurology, University of New Mexico, Albuquerque.
Insights
Anterior choroidal artery territory infarctions are typically caused by small-vessel disease, not carotid artery stenosis or cardiac emboli. This study investigated causes in 31 patients, finding limited evidence for these common stroke risk factors.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Anterior choroidal artery territory infarctions are a specific type of stroke.
- Causes often include atherosclerosis, carotid artery stenosis, and cardiac emboli.
- Small-vessel disease is a potential, less-studied cause.
Purpose of the Study:
- To determine the primary causes of infarction in the anterior choroidal artery territory.
- To evaluate the prevalence of carotid artery stenosis and cardiac sources of emboli in these patients.
- To investigate the role of small-vessel disease.
Main Methods:
- Computed tomography (CT) documented infarction in 31 patients.
- Carotid artery studies (arteriography or duplex ultrasound) were performed.
- Echocardiography was conducted in 15 patients.
- Risk factors for atherosclerosis were recorded.
Main Results:
- Extracranial carotid artery stenosis was found in 13% of patients, similar to asymptomatic individuals.
- Intracranial carotid artery stenosis and cardiac sources of emboli were rare (6% each).
- Common atherosclerosis risk factors like hypertension and smoking were prevalent.
Conclusions:
- Infarctions in the anterior choroidal artery territory predominantly result from small-vessel disease.
- Carotid artery stenosis and cardiac emboli are infrequent causes in this territory.
- Further research into small-vessel disease mechanisms is warranted.
Abstract:
To investigate the cause(s) of infarction in the anterior choroidal artery territory, we studied 31 patients (18 men, 13 women) aged 19-82 (mean 58) years, with infarction in this territory documented by computed tomography. All patients were evaluated within 30 days after infarction and had carotid artery studies (arteriography in 17, duplex ultrasound in 14). Fifteen patients had echocardiography. Risk factors for atherosclerosis were chronic hypertension in 20 patients, smoking in 17, diabetes in 10, age greater than 69 years in eight, and elevated serum cholesterol concentration in three. The percentage of patients with extracranial carotid artery stenosis (four of 31, 13%) and the severity of stenosis (mild in two, moderate in two) were similar to that reported in neurologically asymptomatic individuals. The percentage of patients with intracranial carotid artery stenosis (one of 17, 6%) or potential cardiac sources of emboli (two of 31, 6%) was also low. Our findings suggest that infarctions in the anterior choroidal artery territory usually result from small-vessel disease. Associated carotid artery stenosis and potential sources of cardiac emboli are rare and may be coincidental.