Anterior Choroidal Artery Occlusion Is a Target for Revascularization in Acute Internal Carotid Artery Occlusion With Patent Middle Cerebral Artery

An 88‐year‐old woman presented with sudden‐onset dysarthria and left hemiparesis. The National Institutes of Health Stroke Scale score was 17. Computed tomography angiography showed right internal carotid artery occlusion with preserved middle cerebral artery perfusion via the anterior communicating artery. Perfusion imaging revealed hypoperfusion in the right posterior limb of the internal capsule. Intravenous thrombolysis and mechanical thrombectomy achieved complete recanalization with neurological improvement. Follow‐up magnetic resonance imaging showed infarction in the right corona radiata but not in the internal capsule. The improvement was attributed to reperfusion of the internal capsule territory supplied by the anterior choroidal artery.