Clinical importance of the anterior choroidal artery: a review of the literature

Abstract

The anterior choroidal artery (AChA) is a critical artery in brain physiology and function. The AChA is involved in many diseases, including aneurysm, brain infarct, Moyamoya disease (MMD), brain tumor, arteriovenous malformation (AVM), etc. The AChA is vulnerable to damage during the treatment of these diseases and is thus a very important vessel. However, a comprehensive systematic review of the importance of the AChA is currently lacking. In this study, we used the PUBMED database to perform a literature review of the AChA to increase our understanding of its role in neurophysiology. Although the AChA is a small thin artery, it supplies an extremely important region of the brain. The AChA consists of cisternal and plexal segments, and the point of entry into the choroidal plexus is known as the plexal point. During treatment for aneurysms, tumors, AVM or AVF, the AChA cisternal segments should be preserved as a pathway to prevent the infarction of the AChA target region in the brain. In MMD, a dilated AChA provides collateral flow for posterior circulation. In brain infarcts, rapid treatment is necessary to prevent brain damage. In Parkinson disease (PD), the role of the AChA is unclear. In trauma, the AChA can tear and result in intracranial hematoma. In addition, both chronic and non-chronic branch vessel occlusions in the AChA are clinically silent and should not deter aneurysm treatment with flow diversion. Based on the data available, the AChA is a highly essential vessel.

Intraventricular Hemorrhage due to a Distal Anterior Choroidal Artery Aneurysm Associated with an Arteriovenous Malformation in the Trigone

“…6) However, although distal AChA aneurysms associated with an AVM have rarely been reported, cerebral aneurysms associated with AVMs have been well described. 2) According to the classification of arterial AVM-associated intracranial aneurysms established by Redekop et al, 7) aneurysms are categorized as intranidal, flowrelated, or unrelated to the AVM. Moreover, flow-related aneurysms are classified as distal and proximal.…”

“…1) Moreover, treatment of an AVM fed by an AChA is often complicated because the nidus is located deep inside of the temporal lobe and the AChA supplies extremely critical regions of the brain. 2) We herein report a case of intraventricular hemorrhage (IVH) due to a distal AChA aneurysm associated with a micro-AVM in the trigone of the lateral ventricle, where endovascular embolization for the aneurysm and nidus was performed.…”

Embryological development of the human cranio-facial arterial system: a pictorial review

“…Later on, the ACA pericallosal branches to the choroidal plexus elongate and regress. This AChA-PChA anastomosis is named "limbic arterial arch" and in some cases may persist in the adult life [9,27,43] (Figs. 3,4,5,6).…”

“…The pDOA is now fully developed, supplying a plexus to the OpV; the shorter pVOA is also well recognizable, rising near the junction between the ICA and PCoA [ 11 , 20 , 27 , 32 ]. Several branches now appear from the cranial division of the ICA: the most important of these is the primitive anterior choroidal artery (AChA), coursing along the outlining choroid fissure in the diencephalon [ 20 , 27 , 30 , 43 ]. Some small sprigs arise distally to this branch representing the stem of the MCA [ 20 , 27 ].…”

“…The definitive conformation of the cranial division of the ICA is well identifiable. The first collateral of this cranial division is the AChA [ 20 , 27 , 30 , 43 ]. The second one is the primitive MCA, and the next and more distal branch is the stem of the ACA, at the terminal end of the cranial ICA division (the primitive olfactory artery, pOlfA) [ 11 , 20 , 25 , 27 ].…”