# Unusual Anterior Choroidal Artery Occlusion in Pediatric Type 1 Diabetes: A Case Report Highlighting Atypical Presentation

## TL;DR

A 13-year-old girl with type 1 diabetes had a rare stroke in a brain artery, showing an unusual and severe complication of diabetes in children.

## Contribution

This case report highlights an atypical AChA occlusion in a pediatric type 1 diabetes patient without common risk factors.

## Key findings

- MRI showed a subacute-chronic infarct in the entire left AChA territory.
- The stroke occurred without cardioembolic risk factors or internal carotid artery stenosis.
- The case suggests diabetes alone can cause severe AChA strokes in children.

## Abstract

Anterior choroidal artery (AChA) occlusion is a rare but significant vascular event that can lead to severe neurological deficits. Type 1 diabetes mellitus is a known risk factor for various vascular complications, although its association with AChA occlusion in pediatric patients is not commonly seen. A 13-year-old girl, a known case of type 1 diabetes for three years, presented with right-sided headache, visual disturbance in the right eye, and nausea. Magnetic resonance imaging (MRI) of the brain revealed subacute-chronic infarct in the entire left AChA. Internal carotid artery (ICA) stenosis or cardioembolism are the most common causes of complete AChA ischemic strokes. On the other hand, diabetes mellitus, hypertension, and hyperlipidemia usually cause smaller strokes that only affect a part of AChA territory. However, in our case, there was infarct in the entire AChA territory without any cardioembolic risk factor and in the absence of ICA stenosis.