Takeuchi I, Takagi M, Yamagata S, Hoshino H, Takagi Y
Department of Neurology, Tokyo Saiseikai Central Hospital.
Rinsho Shinkeigaku. 1992 Oct;32(10):1125-9.
The posterior choroidal artery supplies the lateral geniculate body, the posterior thalamus and the caudate body. Currently, a few cases of infarction in this arterial territory have been reported. This is a case of 59-year-old male, exhibiting left homonymous hemianopsia and left hemiparesis. Clinically it was impossible to make a diagnosis of infarction in this area. We were able to determine that it was a posterolateral choroidal artery infarction rather than an anterior choroidal artery infarction using 1.5 T-magnetic resonance imaging (MRI). The MRI scan clearly disclosed the areas of infarction, which included the lateral geniculate body, the posterior thalamus and the caudate nucleus body. Additionally, cerebral angiography revealed an occluded proximal portion of the right posterior cerebral artery (P2) and a patent right anterior choroidal artery. Anatomically, the areas surrounding the lateral geniculate body are supplied by both the anterior and the posterolateral choroidal arteries. However, the posterolateral choroidal artery infarctions are believed to be rare due to usual dominance of the anterior choroidal artery. Presently, with the use of MRI scanning, these areas can be easily visualized. Therefore, the posterolateral choroidal artery infarction can be diagnosed more easily. It is conceivable that more cases will be accurately diagnosed using this tool.
脉络膜后动脉供应外侧膝状体、丘脑后部和尾状核体。目前,已有少数该动脉供血区域梗死的病例报道。这是一例59岁男性患者,表现为左侧同向性偏盲和左侧偏瘫。临床上无法诊断该区域梗死。我们通过1.5T磁共振成像(MRI)确定这是一例脉络膜后外侧动脉梗死而非脉络膜前动脉梗死。MRI扫描清晰显示了梗死区域,包括外侧膝状体、丘脑后部和尾状核体。此外,脑血管造影显示右侧大脑后动脉(P2)近端闭塞,右侧脉络膜前动脉通畅。从解剖学角度来看,外侧膝状体周围区域由脉络膜前动脉和脉络膜后外侧动脉共同供血。然而,由于脉络膜前动脉通常占优势,脉络膜后外侧动脉梗死被认为较为罕见。目前,通过MRI扫描,这些区域能够轻易被观察到。因此,脉络膜后外侧动脉梗死更容易被诊断。可以想象,使用该工具将能更准确地诊断更多病例。