Skip to main content
SpringerLink
Log in

MRI of hyperacute stroke in the AChA territory

  • Neuro
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The purpose of our study was to derive from the anatomical literature an easy-to-use map of the brain areas supplied by the anterior choroidal artery (AChA) and to assess the correspondence between damage within the putative AChA areas and clinical symptoms. A thorough review of the literature led to the recognition of 16 anatomical areas which could be delineated on routine diffusion-weighted MR images. A database of 138 consecutive ischemic stroke patients examined with MRI less than 6 h after symptoms onset was thereafter processed in a retrospective way. Patients presenting with at least one damaged AChA area were selected so as to assess the prevalence of AChA infarction and the clinical correlates of the condition. Fifteen patients (11%) had at least one damaged AChA area. Only two of them had “pure” AChA-restricted infarction. Contralateral hemiparesis and contralateral hemianesthesia were best predicted by lesions within the tail of the caudate nucleus with a sensitivity of 87% and 83%, respectively. Homonymous hemianopsia best correlated with lesions within the posterior limb of the internal capsule and within the retrolenticular part of the internal capsule, with a sensitivity of 100% and a specificity of 70% for both areas. We concluded that the clinical–radiological correlations did not match the neurophysiological standards, thereby highlighting the limitation of this study, which involved a cohort of acute stroke patients recruited from clinical practice and investigated the clinical impact of these brain lesions, even when documented with the most sensitive imaging modality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Beevor CE (1907) The cerebral arterial supply. Brain 30:403–425

    Google Scholar 

  2. Abbie AA (1933) The clinical significance of the anterior choroidal artery. Brain 56:233–246

    Google Scholar 

  3. Alexander L (1942) Vascular supply of the strio-pallidum. Res Nerv Ment Dis Proc 21:77–132

    Google Scholar 

  4. Carpenter MB, Noback CR, Moss ML (1954) The anterior choroidal artery: its origin, course, distribution, and variations. Arch Neurol Psychiatr 71:714–722

    Google Scholar 

  5. Herman L, Fernando O, Gurdjian E (1966) The anterior choroidal artery: an anatomical study of its area of distribution. Anat Rec 154:95–102

    CAS  PubMed  Google Scholar 

  6. Furlani J (1973) The anterior choroidal artery and its blood supply to the internal capsule. Acta Anat 85:108–112

    CAS  Google Scholar 

  7. Takahashi S, Fukasawa H, Ishii K, Sakamoto K (1994) I. Microangiography of the anterior choroidal artery. Neuroradiology 36:337–339

    CAS  PubMed  Google Scholar 

  8. Morandi X, Brassier G, Darnault P, Mercier Ph, Scarabin JM, Duval JM (1996) Microsurgical anatomy of the anterior choroidal artery. Surg Radiol Anat 18:275–280

    CAS  PubMed  Google Scholar 

  9. Marinkovic S, Gibo H, Brigante L, Nikodijevic I, Petrovic P (1999) The surgical anatomy of the perforating branches of the anterior choroidal artery. Surg Neurol 52:30–36

    Article  CAS  PubMed  Google Scholar 

  10. Percheron G (1977) Les artères du thalamus humain. Les artères choroïdiennes. Rev Neurol (Paris) 10:547–558

    Google Scholar 

  11. Rosner SS, Rhoton AL Jr, Ono M, Barry M (1984) Microsurgical anatomy of the anterior perforating arteries. J Neurosurg 61:468–485

    CAS  PubMed  Google Scholar 

  12. Marinkovic S, Milisavljevic M, Puskas L (1992) Microvascular anatomy of the hippocampal formation. Surg Neurol 37:339–349

    CAS  PubMed  Google Scholar 

  13. Erdem A, Yasargil MD, Roth P (1993) Microsurgical anatomy of the hippocampal arteries. J Neurosurg 79:256–265

    CAS  PubMed  Google Scholar 

  14. Gavrilescu T, Kase CS (1995) Clinical stroke syndromes: clinical-anatomical correlations. Cerebrovasc Brain Metab Rev 7:218–239

    CAS  PubMed  Google Scholar 

  15. Grunwald I, Reith W (2002) Non-traumatic neurological emergencies: imaging of cerebral ischemia. Eur Radiol 12:1632–1647

    Article  PubMed  Google Scholar 

  16. Tanenbaum LN (2002) CT of acute stroke in the clinical setting. Eur Radiol 12(Suppl. 2):S25–S32

    Google Scholar 

  17. Ahlhelm F, Schneider G, Backens M, Reith W, Hagen T (2002) Time course of the apparent diffusion coefficient after cerebral infarction. Eur Radiol 12:2322–2329

    CAS  PubMed  Google Scholar 

  18. Frisen L (1979) Quadruple sectoranopia and sectorial optic atrophy: a syndrome of the distal anterior choroidal artery. J Neurol Neurosurg Psychiat 41:374–380

    Google Scholar 

  19. Decroix JP, Graveleau PH, Masson M, Cambier J (1986) Infarction in the territory of the anterior choroidal artery: a clinical and computerized study in 16 cases. Brain 109:1071–1085

    PubMed  Google Scholar 

  20. Paroni Sterbini GL, Agatiello LM, Stocchi A, Solivetti FM (1987) CT of ischemic infarctions in the territory of the anterior choroidal artery: a review of 28 cases. Am J Neuroradiol 8:229–232

    PubMed  Google Scholar 

  21. Helgason CM, Wilbur AC (1990) Capsular hypesthetic ataxic hemiparesis. Stroke 21:24–33

    CAS  PubMed  Google Scholar 

  22. Mohr JP, Steinke W, Timsit SG, Sacco RL, Tatemichi TK (1991) The anterior choroidal artery does not supply the corona radiata and lateral ventricular wall. Stroke 22:1502–1507

    CAS  PubMed  Google Scholar 

  23. Takahashi S, Ishii K, Matsumoto K et al (1994) The anterior choroidal artery syndrome. II. CT and/or MR in angiographically verified cases. Neuroradiology 36:340–345

    CAS  PubMed  Google Scholar 

  24. Duret H (1874–1875) Recherches anatomiques sur la circulation de l’encéphale. Arch de Physiol Norm et Path. Paris pp 6, 60, 316 (1874); 664 (1875)

  25. Heubner O (1874) Die luetische erkrankung der hirn-artieren nebst allgemeinen erörterungen zur normalen und pathologischen Histologie der arterien sowie zur hirncirculation. F.C.W. Vogel, Leipzig

  26. Kolisko A (1891) Über die Bezeihung der arteria choroïdea anterior zum hinteren Schenkel der inneren Kapsel des Gehirnes. A. Hölder, Vienna

  27. Ley LR (1932) Contribution à l’étude du ramollissement cérébral, envisagée au point de vue de la pathogénie de l’ictus apoplectique. J Neurol Psychiat 32:785–895

    Google Scholar 

  28. Buge A, Escourolle R, Hauw JJ, Rancurel G, Gray F, Tempier P (1979) Syndrome pseudobulbaire aigu par infarctus bilatéral limité du territoire des artères choroidiennes antérieures. Rev Neurol (Paris) 135:313–318

    Google Scholar 

  29. Bogousslavski J, Regli F, Delaloye-Bischoff A, Uske A, Despland PA (1986) Hémiataxie et déficit sensitif ipsilatéral: infarctus du territoire de l’artère choroïdienne antérieure. Diaschisis cérébelleux croisé. Rev Neurol (Paris) 142:671–676

    Google Scholar 

  30. Graff-Radford NR, Damasio H, Yamada T, Eslinger PJ, Damasio AR (1986) Non hemorragic thalamic infarction. Brain 108:485–516

    Google Scholar 

  31. Helgason C, Caplan LR, Goodwin J, Hedges T III (1986) Anterior choroidal artery-territory infarction. Report of cases and review. Arch Neurol 43:681–686

    CAS  PubMed  Google Scholar 

  32. Hupperts RMM, Lodder J, Heuts-van Raak EPM, Kessels F (1994) Infarcts in the anterior choroidal artery territory. Anatomical distribution, clinical syndromes, presumed pathogenesis, and early outcome. Brain 117:825–834

    PubMed  Google Scholar 

  33. Bruno A, Graff-Radford NR, Biller J, Adams HP Jr (1989) Anterior choroidal artery territory infarction: a small vessel disease. Stroke 20:616–619

    CAS  PubMed  Google Scholar 

  34. Osborn AG (1999) Diagnostic cerebral angiography. Lippincott Williams and Wilkins, Philadelphia, p 101

  35. Mounier-Kuhn A, Bouchet A, Costaz G (1955) Contribution à l’étude anatomique, radiologique et chirurgicale de l’artère choroïdienne antérieure. Neurochirurgie 4:345–370

    Google Scholar 

  36. Kaplan HA, Ford OH (1966) The brain vascular system. Elsevier Science Publishing Co Inc, Amsterdam

  37. Osborn AG (1980) Introduction to cerebral angiography. Harper and Row Publishers, Hagerstown, pp 167–184

  38. Granier I, Grandin CB, Duprez Th, Smith AM, Peeters A, Cosnard G (2000) Predictive value of MR 3D-TOF angiography and T2 Fast-FLAIR sequence to detect hemodynamic disturbance at the hyperacute phase of stroke. J Neuroradiol 27:119–127

    CAS  PubMed  Google Scholar 

  39. Levy R, Duyckaerts C, Hauw JJ (1995) Massive infarcts involving the territory of the anterior choroidal artery and cardioembolism. Stroke 26:609–613

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Ms Julie Francart, MSc, member of the Epidemiology and Biostatistics Unit at the Public Health School of the Université Catholique de Louvain, for kindly supervising the statistics in the article.

Author information

Authors and Affiliations

  1. Department of Medical Imaging, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium

    Xavier L. Hamoir, Cécile B. Grandin, Guy Cosnard & Thierry Duprez

  2. Department of Neurology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium

    André Peeters

  3. Department of Epidemiology, Biostatistics Unit of the Public Health School, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium

    Annie Robert

Authors
  1. Xavier L. Hamoir
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cécile B. Grandin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. André Peeters
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Annie Robert
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Guy Cosnard
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thierry Duprez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thierry Duprez.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hamoir, X.L., Grandin, C.B., Peeters, A. et al. MRI of hyperacute stroke in the AChA territory. Eur Radiol 14, 417–424 (2004). https://doi.org/10.1007/s00330-003-2220-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-003-2220-1

Keywords

Search

Navigation