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Version vom 27. Juni 2024, 09:22 Uhr
Definition
The anterior choroidal artery, or AChA for short, is a vascular branch of the internal carotid artery.
Anatomy
Course
The anterior choroidal artery usually arises from the cerebral artery of the internal carotid artery (C7 segment according to Bouthillier). The origin lies approximately 2 to 5 mm before the bifurcation into the anterior cerebral artery and the middle cerebral artery and 2 to 5 mm after the exit of the posterior communicating artery (PCom).
The artery, which is on average 0.8 mm thick, runs adjacent to the base of the brain between the optic tract and the medial edge of the temporal lobe. It first runs lateral to the tractus and then bends medially to its inferomedial surface. It then runs laterally of the tractus again, runs around the pedunculi cerebri and reaches the corpus geniculatum laterale. In the last section of the cisternal segment, which is approx. 2.5 cm long, the AChA runs in a posterolateral direction above the uncus parahippocampalis in order to enter the choroid fissure of the lateral ventricle. From this so-called plexus point, the artery runs intraventricularly.
Branches
The anterior choroidal artery gives off the following branches:
- Rami choroidei ventriculi lateralis: to the choroid plexus of the temporal horn of the lateral ventricle
- Rami substantiae perforatae anterioris: to the substantia perforata anterior
- Rami chiasmatici: to the optic chiasm
- Rami tractus optici: to the optic tract
- Rami corporis geniculati lateralis: to the corpus geniculatum laterale
- Rami cruris posterioris capsulae internae: to the capsula interna
- Rami globi pallidi: to the globus pallidus
- Rami caudae nuclei caudati: to the caudate nucleus
- Rami hippocampi: to the hippocampus
- Rami corporis amygdaloidei: to the amygdala
- Rami nucleorum thalami: to the thalamus
- Rami substantiae nigrae et nuclei rubri: to the substantia nigra and the nucleus ruber
- Rami cruris cerebri: to the crus cerebri
Supply area
The anterior choroidal artery supplies a large number of brain structures with the branches mentioned above. These include, for example:
- posterior crus and retrolenticular part of the internal capsule incl. optic radiatio
- lateral thalamus incl. corpus geniculatum laterale
- optic chiasm, optic tract
- lateral pedunculus cerebri, substantia nigra, nucleus ruber
- globus pallidus internus
- Cauda nuclei caudati
- mesial temporal lobe: Uncus parahippocampalis, amygdala
- choroid plexus of the temporal horn of the lateral ventricles
Norm variants
The AChA rarely arises from the middle cerebral artery or the posterior communicating artery. In about 5 % of cases, the AChA is double. In hyperplastic AChA, the vessel can take over supply areas of the posterior cerebral artery.
Clinic
A cerebral infarction in the area of the internal choroidal artery can lead to anterior choroidal artery syndrome. It is characterised by:
- Hemiparesis
- hemianaesthesia
- contralateral hemianopsia
Furthermore, a left hemineglect can occur with right-sided lesions and speech disorders with left-sided lesions. Incomplete forms with lacunar syndromes and ataxic hemiparesis are more common.