A 50-year-old male patient presented to the ER with weakness of both upper and lower limb on the right side along with sensory loss in similar distribution. O/E Homonymous hemianopia. Hearing loss MRI head AXIAL FLAIR AXIAL DWI Which of the following aery is most likely involved in the above case?
OPTION A IS ANTERIOR CEREBRAL AERY OPTION B IS ANTERIOR CHOROIDAL AERY OPTION C IS POSTERIOR CEREBRAL AERY OPTION D IS POSTERIOR COMMUNICATING BRANCH EXPLANATION: - This is a case of anterior choroidal aery syndrome. 1. Localization: -Dense hemiparesis with equal weakness of upper and lower limb = lesion of internal capsule. 2. An aery which supplies the posterior limb of the internal capsule as well as sublentiform pa and the retrolentiform pa is the anterior choroidal aery. - Because patient had homonymous hemianopia and hearing loss. 3. MRI shows Abnormal signal and diffusion restriction involving: - Left hippocampus Posterior limb of left internal capsule - suggestive of acute infarction along anterior choroidal aery distribution 4. Vascular territory of anterior choroidal aery Hippocampus and amygdala Posterior limb of the internal capsule Optic tract Lateral geniculate nucleus and lateral aspect of thalamus Lateral aspect of the midbrain Choroid plexus of the anterior pa of the temporal horns of the lateral ventricles
AERY A
AERY B
AERY C
AERY D
Integrated QBank