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Cathy M. Helgason, MD
Department of Neurology University of Illinois at Chicago 912 S Wood St Chicago, IL 60612

Louis R. Caplan, MD
Department of Neurology Tufts New England Medical Center Boston, MA 02111

James A. Goodwin, MD
Department of Ophthalmology University of Illinois at Chicago

Thomas Hedges III, MD
Department of Neuro-ophthalmology Tufts New England Medical Center

Arch Neurol. 1987;44(9):897.

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—We agree that the mechanism of bilateral pallidal necrosis as seen in hypoxic-ischemic brain injury is probably not related to anterior choroidal artery (AchA) compression, but rather metabolically mediated and due to selective vulnerability. Computed tomographic scans in our cases¹ and those of Decroix et al² of AchA infarcts always included involvement of the posterior limb of the internal capsule as do all necropsy cases.^3-7 Furthermore, hypoxic ischemic injury also involves the thalamus and other structures distant from the AchA, and many patients have no evidence of brain swelling. . . . [Full Text PDF of this Article]

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