The aim of our study is to explore the clinical features, possible mechanism and prognosis of AchA infarcts.

Acute ischemic stroke (AIS) in the anterior choroidal artery (AChA) territory is commun in daily practice. But its clinical and evolutionary characteristics are not very obvious, hence the interest of our study.

A total of 33 AChA infarction patients were recruited in the study retrospectively from 2018 to 2021. Demographic and clinical characteristics were analyzed in all patients.

Among ischemic stroke, 33 of 408 patients (8.08%) were enrolled with isolated AChA infarct. Most of patients were male (78.8%). The mean age was 61 years. The most common risk factors were hypertension and diabetes, smoking followed by coronary arterial heart disease. Hemiparesis was the most common clinical manifestation (78.8%), followed by slurred speech/aphasia (63.5%), hemianesthesia (48.5%), hemianopia (9.1%) and finally ataxia (6.1%). Average NIHSS was 5.8.  Only 3 patients (6.1%) received intravenous thrombolysis. 60% of patients were treated with double antiplatelet. mRankin score (mRS) was higher in patients treated with simple antiplatelet (p=0.04). The stroke etiology included large artery disease (36.4%), small vessel disease (27.3%), cardio-embolic (9.1%). Ischemic stroke is of undetermined cause in 27.2%. Among 33 AChA infarcts, 54.8% of patients got good prognosis (mRS score≤2). Prognosis of infarction of AChA stroke depend on etiology. Cardio-embolic mecanism had poor outcome (p=0.03).

According to the results obtained in this study, and taking into account their limitations of the small sample, choroidal stroke has a good prognosis. But the interest of intravenous thrombolysis is not demonstrated yet, which requires a subsequent multicenter study.