Chausson N, et al. JSCD; 2014; 23:8: 2012-7.
Authors describe the phenotypes of anterior choroidal stroke in heretofore unappreciated ways. They prospectively enrolled patients with AChA disease
*One hundred patients were found out of 1234 total (8.1 %) who had AChA strokes
* Main risk factors found were hypertension and (79 %) and diabetes (31 %).
* 88 % had "lacunar" (motor syndrome in 51, sensorimotor in 23, ataxic hemiparesis in 14, isolated ataxia in 4, other 7)
* only four patients had hemianopia
* cardioembolic and atherothrombotic causes wee rare
* 3 % mortality but 26 % poor outcomes, invariably due to residual motor deficit and/or spasticity
* Progressive strokes were seen in 46, and 16 with fluctuations, wiht progressions over a mean of 56 hours and being almost exclusively motor
* Use of iv tpa did nto help prevent progression (tpa was used in 12/46 progressors and 9/54 nonprogressors)
* predictor of poor outcome was those who reached an NIHSS of 6 or greater, clinical progression, and infarct size > 15 mm
* Progression was nearly always due to infarct expansion on DWI
* Authors suggest new treatments are needed for this disease.
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