Abstract
A rare case of Abbie's syndrome, or anterior choroidal artery (Ach) syndrome, is reported. The patient was a 61-year-old hypertensive man, who presented with a left motor-hemiplegia and a left homonymous hemianopsia and no sensory disturbance on admission.
Internal carotid angiography disclosed an occlusion of the right Ach at its origin. CT scan and MRI revealed infarctive foci in the posterior two-thirds of the posterior limb of the internal capsule, the lateral half of the lateral geniculate body, the optic radiation and the uncus, all on the right side. However, the posterior end of the posterior limb of the right internal capsule did not appear involved. IMP-SPECT disclosed a diffuse hypoperfusion area in the affected cerebral hemisphere in the early image and re-distribution phenomenon around the basal ganglia including the posterior limb of the right internal capsule in the delayed image. Findings of other examinations such as urinalysis, blood biochemistry, chest X-ray, electrocardiography and echocardiography were all within normal limits. After undergoing medical and physical therapy for one and a half months, the patient was discharged with a mild left hemiparesis and a persistent complete left hemianopsia.
Previous reports of primary Abbie's syndrome, though very few, have implied that both motor and sensory hemipareses corresponding to the vascular distribution are inevitable in case of Ach occlusion. However, our patient did not demonstrate sensory disturbance of any modality. This may be explained by preservation of the posterior end of the posterior limb of the right internal capsule, through which the sensory fibers run. Sparing of this region may be attributed to collateral blood supply from the middle cerebral, the posterior cerebral, or, most likely, from the lateral posterior choroidal, arteries.
