Anterior choroidal artery infarction: a clinical, etiologic and prognostic study

Objectives –  To analyze the clinical, etiologic and prognostic profile of anterior choroidal artery (AChA) infarcts.
Methods –  42 consecutive patients with AChA infarction were included. Symptoms, etiology and scores on neurological and functional scales were analyzed on admission, discharge and at 3-month follow-up. A comparative study was performed between deep ( n  = 23) and deep + superficial ( n  = 19) infarcts.
Results –  Lacunar syndrome was present in 83.3% of patients. Etiology was large-vessel disease in 38.1% and cryptogenic in 38.1%. Ten patients had a National Institute of Health Stroke Scale score >7 on admission. At discharge, 45.3% had an modified Rankin Scale >2 (35.7% after 3 months). Infarcts involving superficial territory were more severe at admission ( P  = 0.034) and were associated with a worse functional status at discharge ( P  = 0.0008).
Conclusion –  AChA infarcts usually present with lacunar syndrome, although they are often not lacunar infarcts. At discharge, almost half of the patients are dependent in their activities of daily living, and most remain so at 3-month follow-up. Infarcts involving superficial territory are associated with worse prognosis.