Posterior Choroidal-Artery Infarct with Homonymous Horizontal Sectoranopia

Besson, Gérard; Bogousslavsky, Julien; Régli, F

doi:10.1159/000108828

Cited by 17 publications

(5 citation statements)

References 6 publications

(7 reference statements)

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“…Horizontal sectoranopsia corresponds to involvement of the central part of the LGB, which is supplied by the lat- and sparing the middle horizontal sector [9, 341. Nevertheless, the occurrence of upper or lower quadrantanopsia in PChA territory infarct indicates that the lateral PChA may also commonly supply the medial or lateral part of the LGB [8]. Sensorimotor dysfunction was more frequent in our series than in previously reported cases [4, 7,9,271.…”

Section: Discussioncontrasting

confidence: 51%

“…These visual field defects, initially described as incongruent [33], may show a good congruency [9] as also found in our patients. It has been suggested [4, 8,91 that the representation of the visual field within the LGB could explain the visual field defect patterns, with the lower retinal quadrant occupying the anterolateral part of the LGB, while the upper retinal quadrant occupies the anteromedial part of the LGB and the macula is represented in the posterior pole of the LGB (Fig 4). Moreover, the different possibilities of visual field defect in LGB infarction may be explained by its dual (posterior plus anterior circulation systems) blood supply.…”

Section: Discussionmentioning

confidence: 99%

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The syndrome of posterior choroidal artery territory ifarction

Neau¹,

Bogousslavsky²

1996

Annals of Neurology

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114

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Posterior choroidal artery (PChA) territory infarcts remain the least well-known type of thalamic infarcts. Our study of 10 personal cases, selected from 2,925 stroke patients admitted consecutively to a community-based primary care center, and 10 published cases of unilateral PChA territory infarct suggests that they can often be differentiated clinically from other thalamic infarcts. Patients with PChA territory infarct associated with superficial posterior cerebral artery territory infarct or with another infarct were excluded. Damage was characteristically limited to the lateral geniculate body, pulvinar, posterior thalamus, hippocampus, and parahippocampal gyros, without involvement of the upper midbrain and the anterior nucleus of thalamus. In lateral PChA territory infarct, the most common clinical manifestations included homonymous quadrantanopsia, with or without hemisensory loss and neuropsychological dysfunction (transcortical aphasia, memory disturbances). A homonymous horizontal sectoranopsia is exceptional but particularly suggestive of the involvement of the lateral geniculate body in this territory. Media] PChA territory infarct was less frequent. Its neurologic picture was dominated by eye movement disorders not particularly suggestive of thalamic involvement. Late disability was usually absent or slight, being related to pain and delayed abnormal movements. The most common stroke etiology was presumed small-vessel occlusive disease.

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Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

The syndrome of posterior choroidal artery territory ifarction

Neau¹,

Bogousslavsky²

1996

Annals of Neurology

Self Cite

114

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“…The medial posterior choroidal arter ies supply the habenula, anteromedial pulvinar, medial part of the centromedian nuclei, and the paramedial nuclei [6]. Only two necropsy-proven infarcts in the poste rior choroidal artery territory have been published [25], A 52-year-old man was confused and dysphasic [77], A 67-year-old woman had abnormal vertical eye movements and retractory nystagmus and later developed a hemiparesis [78], Recently, clinical-radiographic correlation using CT and MRI of patients with infarcts localized to posterior choroidal artery territory have been reported [79][80][81]. In nearly all, the vascular lesion was not defined.…”

Section: Unilateral Paramedian Thalamic-subthalamic Artery Territory mentioning

confidence: 99%

Vertebrobasilar Occlusive Disease: Review of Selected Aspects

Bogousslavsky

Caplan

1993

Cerebrovasc Dis

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Knowledge of the vascular anatomy and supply zones of the thalamus helps interpret the findings in patients with thalamic infarcts. Occlusion of various thalamic arteries arising from the basilar apex, posterior cerebral arteries, and posterior communicating arteries gives rise to prototypic clinical findings and imaging abnormalities. Risk factor analysis, ultrasound, newer cardiac tests and magnetic resonance angiography now make it possible in the majority of patients, to define the most likely etiology of the thalamic infarcts noninvasively. Treatment depends on the nature, location and severity of the vascular lesion, and extent of brain infarction.

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“…10 Hemineglect in right-sided infarcts and mild aphasia in leftsided infarcts are other usual findings.…”

mentioning

confidence: 96%

Anterior choroidal artery territory infarcts. Study of presumed mechanisms.

Leys

Mounier‐Véhier

Lavenu

et al. 1994

Stroke

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A previous study suggested that occlusive diseases of small penetrating arteries account for most anterior choroidal artery (AChA) territory infarcts, but half of the patients did not have an echocardiogram. Cases of AChA territory infarcts associated with internal carotid artery stenosis or atrial fibrillation suggest that this hypothesis may be wrong. The aim of this study was to determine the mechanism of 16 nonselected consecutive AChA territory infarcts. The study population consisted of 8 men and 8 women aged 17 to 89 years. They underwent a computed tomographic scan at the acute stage, Doppler ultrasonography and B-mode echotomography of the cervical arteries, bidimensional transthoracic echocardiography, and cerebral magnetic resonance imaging, replaced by a second computed tomographic scan in 3 patients. Ten patients underwent cerebral angiography. We defined the presumed cause of stroke according to the criteria used in the trial of Org 10172 in acute stroke treatment. The presumed cause of stroke was definite cardio-embolism in 4 patients (atrial fibrillation in 2, paradoxical embolism in 1, and left ventricular akinesia in 1); definite large-vessel atherosclerosis in 2; dissection of the internal carotid artery in 2; and definite small-vessel occlusion in 1. Seven patients had a negative diagnostic workup. Six patients had no risk factors for small-vessel occlusion. The AChA was not visible on angiography in 4 patients. One patient had two arterial cutoffs, suggestive of emboli in other cerebral arteries. This study suggests that AChA territory infarcts are rarely related to small-vessel occlusion and therefore require a complete diagnostic workup.

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Posterior Choroidal-Artery Infarct with Homonymous Horizontal Sectoranopia

Cited by 17 publications

References 6 publications

The syndrome of posterior choroidal artery territory ifarction

The syndrome of posterior choroidal artery territory ifarction

Vertebrobasilar Occlusive Disease: Review of Selected Aspects

Anterior choroidal artery territory infarcts. Study of presumed mechanisms.

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