title: Bilateral anterior choroidal artery infarction presenting with progressive somnolence.
abstract: A 55-year-old woman was admitted with a 3 days history of increasing lethargy with bradyphrenia and apathy. She progressively developed severe somnolence with marked abulia, right hemiparesis, right hemianopsia, and pseudobulbar palsy. Brain magnetic resonance imaging showed the rare image of bilateral acute anterior choroidal artery infarction. Pseudobulbar mutism and in rare cases abulia have been described in acute anterior choroidal artery infarction contralateral to an older lesion in mirror position. Although neurologic deterioration is not infrequent in anterior choroidal artery territory infarcts, the absence of focal neurologic signs on admission is rare and did not raise suspicion of acute stroke.
authors.affiliation: Neurology Department, University Hospitals Leuven, Leuven, Belgium. Electronic address: brechtje.vanson@uzleuven.be.
authors.forename: Brechtje
authors.initials: B
authors.lastname: van Son
authors.affiliation: Radiology Department, Ziekenhuis Oost Limburg, Genk, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Vandevenne
authors.affiliation: Neurology Department, Ziekenhuis Oost Limburg, Genk, Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Viaene
mesh_terms: D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D006970:Disorders of Excessive Somnolence / Q000209:etiology*; D005260:Female; D006423:Hemianopsia / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009155:Mutism / Q000209:etiology; D010291:Paresis / Q000209:etiology
keywords: Ischemic stroke; anterior choroidal artery; bilateral; infarction; somnolence