Percheron infarct with a normal initial MRI: a case report and review of the literature
- Petkov, K. Genova, G. Garvanska, D. Dhimitri
The artery of Percheron is a relatively rare variant, in which a single thalamoperforate artery, known as artery of Percheron arises from the P1 segment of either the left or the right PCA and bifurcates to supply both medial thalami. The territory of this artery sometimes extends both forwards and backwards, including the anterior thalami and the rostral midbrain. The occlusion of this artery gives rise to an infarct with a typical pattern, known as “Percheron infarct”. We present a case of a 74 years old man with a clinical and imaging pattern of a Percheron infarct, which developed after a cardiac surgery. However, the identified level of arterial occlusion suggested a more extensive ischemic injury and the diagnostic work-up was further complicated by the complex clinical background and the inconsistent initial imaging findings. An infarct in the territory of the artery of Percheron could be difficult to diagnose due to relative rarity of the underlying anatomical variant and varying clinical signs. However, this diagnosis should be considered in cases with vertical gaze palsy, altered mental status, memory impairment and bilateral medial thalamic lesions.
Key words: PERSHERON ARTERY. MRI. BILATERAL THALAMIC INFARCT