67.: Posterior choroidal artery stroke with infarction of choroid plexus: A rare manifestation of a common entity

Abstract

Posterior choroidal artery (PChA) infarction is a thalamic infarct syndrome with specific radiological and clinical findings. The posterior choroidal artery has two main divisions, lateral and medial. We describe two patients with PChA infarction who presented with symptoms initially suggestive of anterior circulation ischaemia. Patient 1 is a 64-year-old right-handed man who presented with right-sided weakness, paraesthesia and a 24 h history of word finding difficulty which spontaneously resolved. MRI with diffusion weighted imaging (DWI) demonstrated acute infarcts involving the pulvinar of left thalamus and adjacent choroid plexus, and periventricular white matter adjacent to the left lateral ventricle. Patient 2 is a 57-year-old right-handed man with right upper and lower limb clumsiness and altered sensation. Subsequent MRI with DWI demonstrated an area of infarction affecting the sub-ependymal region along the lateral aspect of the left lateral ventricle, and approximating the posterior body and tail of the caudate nucleus. PChA infarction is rare due to multiple anastamoses. Choroid plexus infarcts are usually clinically silent. There have only been a few reported cases of choroid plexus infarction. We describe two patients with lateral PChA infarction. This is a rare stroke syndrome due to multiple anastamotic connections and produces interesting radiological findings, particularly that of choroid plexus infarction. PChA infarction has variable clinical presentations and can mimic an anterior circulation stroke.