Acute Anterior Choroidal Artery Territory Infarction: A Retrospective Study
Zhe Cheng1, Honglian Duan1, Fanhua Meng1
1Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China.
Insights
Clinical progression in anterior choroidal artery (AChA) strokes is linked to multiple risk factors and large vessel disease. Intravenous thrombolysis therapy (IVT) did not significantly alter progression or prognosis in these patients.
Area of Science:
- Neurology
- Vascular Neurology
- Stroke Medicine
Background:
- Acute ischemic stroke (AIS) in the anterior choroidal artery (AChA) territory presents unique clinical challenges.
- Understanding risk factors and progression patterns is crucial for effective patient management.
Purpose of the Study:
- To investigate the clinical features, risk factors, and progression of AIS in the AChA territory.
- To evaluate the impact of intravenous thrombolysis therapy (IVT) on clinical progression and prognosis.
- To identify factors influencing the prognosis of AChA infarction.
Main Methods:
- Retrospective analysis of 113 patients with AChA infarction.
- Collection and comparison of demographic and clinical characteristics.
- Analysis of clinical progression, outcome, and IVT use.
Main Results:
- Hemiparesis was the most common symptom (92.9%).
- Clinical progression was associated with multiple risk factors, carotid plaques, and stenosis.
- Good prognosis at 6 months was observed in 69.9% of patients; factors like atrial fibrillation and large infarct size were linked to poor outcomes.
- No significant difference in clinical progression or prognosis was found between patients who received IVT and those who did not.
Conclusions:
- Motor deficits are typical in AChA infarcts.
- Large vascular disease, not just small artery disease, may contribute to clinical progression.
- Prognosis is influenced by clinical progression, infarct size, and atrial fibrillation.
- IVT did not appear to prevent clinical progression or improve prognosis in this cohort.
Objectives:
To explore the clinical features, risk factors, etiopathogenesis, mechanism of progression, effect of intravenous thrombolysis therapy (IVT) and prognosis of acute ischemic stroke (AIS) in the anterior choroidal artery (AChA) territory.
Patients And Methods:
A total of 113 AChA infarction patients were enrolled in the current study retrospectively. The demographic and clinical characteristics were collected and analyzed in all patients. The clinical characteristics were compared between clinical progression and no clinical progression groups, good and poor outcome groups, as well as with and without intravenous rt-PA groups.
Results:
Hemiparesis was the most common clinical manifestation (92.9%), followed by dyslexia (54.9%), hemianesthesia (43.4%) and other syndromes. Forty-nine patients (43.4%) suffered from clinical progression and showed a higher rate with multiple risk factors together than patients without clinical progression (30.6% vs.14.1%, P = 0.039). Moreover, more patients with progression were found with carotid plaques (73.5% vs. 51.6%, P = 0.018) or carotid artery stenosis (18.4% vs. 6.3%, P = 0.045) than patients without progression. 69.9% of patients got good prognosis at 6-months. In good prognosis group, the proportion of patients with atrial fibrillation, clinical progression and large infarct size were significantly lower than in poor prognosis group (1.3% vs. 11.8%, P = 0.047; 23.9% vs. 67.6%, P = 0.001; 15.2% vs. 38.2%, P = 0.007). No significant difference was found on rate of clinical progression and good prognosis between patients with and without IVT.
Conclusion:
Motor deficits are the most frequent and typical symptoms in AChA infarcts. Although small artery disease was considered to be the important etiopathogenesis of the AChA infarcts, large vascular disease may be associated with clinical progression in AChA infarcts. Additionally, prognosis of AChA infarcts is correlated with clinical progression, infarct size and atrial fibrillation. IVT does not seem to prevent the clinical progression and improve prognosis of AChA infarcts.
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