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Artery of Percheron

K V Vinod, R Kaaviya, Bhaumik Arpita
Artery of Percheron (AOP) occlusion is a rare cause of ischemic stroke characterized by bilateral paramedian thalamic infarcts, with or without mesencephalic infarction. Clinically it presents with mental state disturbances, hypersomnolence, aphasia/dysarthria, amnesia and ocular movement disorders, including vertical gaze palsy. Here, we report a case of cardioembolic AOP infarction in a 37-year-old woman with rheumatic mitral valvular stenosis. This case is being reported to highlight the interesting clinical and neuroimaging features of this rare condition, and the differential diagnosis of AOP infarction on imaging have been discussed...
July 2016: Annals of Neurosciences
Hye Yeon Lee, Min Jeong Kim, Bo-Ram Kim, Seong-Eun Koh, In-Sik Lee, Jongmin Lee
Bilateral paramedian thalamic infarction is a rare subtype of stroke caused by occlusion of the artery of Percheron, an uncommon variant originating from one of the posterior cerebral arteries. This type of stroke has several major clinical presentations: altered mental status, behavioral amnestic impairment, aphasia or dysarthria, ocular movement disorders, motor deficits, cerebellar signs, and others. Few cases of bilateral paramedian thalamic infarction-related pseudobulbar palsy characterized by dysarthria, dysphagia, and facial and tongue weakness have been reported...
August 2016: Annals of Rehabilitation Medicine
Saritha Aryan, Sumit Thakar, A S Hegde
Infarction in the artery of Percheron territory is a rare phenomenon in which occlusion of an unpaired perforating artery arising from the P1 segment on one side results in infarcts in the bilateral paramedian thalami with or without midbrain infarcts. We describe the case of a 40-year-old male who developed this complication following re-exploratory trans-sphenoidal surgery for a pituitary adenoma. In this first report of its kind in endoscopic pituitary surgery, the pathogenesis and clinico-radiological features of this rare vascular event are discussed...
October 2016: Acta Neurochirurgica
Keisuke Suzuki, Tomoyuki Miyamoto, Masayuki Miyamoto, Hiroto Maeda, Kazuya Nokura, Jun Tohyama, Koichi Hirata, Tetsuo Shimizu, Takashi Kanbayashi
BACKGROUND: Bilateral paramedian thalamic infarctions (BPTIs) due to artery of Percheron occlusion are known to cause hypersomnia. However, the role of hypocretin-1, a wake-promoting peptide that is located at the lateral hypothalamus, in hypersomnia in these patients remains unclear. METHODS: To clarify the role of hypocretin-1 in hypersomnia in patients with BPTIs, hypocretin-1 levels in the cerebrospinal fluid (CSF) were measured in 6 patients with BPTIs: 2 with rostral midbrain involvement (BPT+RMI) and 4 without midbrain involvement (BPT-MI)...
July 2016: Medicine (Baltimore)
Sheng-Feng Lin, Ting-Chun Lin, Han-Hwa Hu, Chin-I Chen
PURPOSE: Occlusion of the artery of Percheron (AOP), a rare vascular variant of basilar artery branch, is presumed to cause bilateral paramedian thalamic infarction. We present a case of acute AOP infarction with status epilepticus. CASE REPORT: A 65-year-old woman had past history of hypertension, type 2 diabetes mellitus, and major depressive disorder. She was found to have altered mental status on awakening. She developed tonic convulsion and progressed to status epilepticus later...
December 2015: Acta Neurologica Taiwanica
Sulena, Paramdeep Singh, Rupinderjeet Kaur, Naveen Kumar
No abstract text is available yet for this article.
April 2016: Indian Journal of Critical Care Medicine
Mahmood Bayan, Suleman Kanani, Alexandra Lupu, Jelena Sergentani, Daniel Varga
No abstract text is available yet for this article.
June 1, 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
Haitham Mazek, Khaled Sherif, Jose Suarez, Jason Wischmeyer
Coronary angiography is the golden choice for coronary artery disease evaluation and management. However, as with any invasive procedures, there is a risk of complications. We are reporting a case of 69-year-old male with past medical history of cardiac bypass surgery, CHF, hypertension, and hyperlipidemia who was admitted to the hospital to evaluate his chest pain. He had treadmill stress test that showed ischemic induced exercise. Patient underwent coronary angiography that showed proximal complete occlusion of the RCA with a patent graft...
2016: Case Reports in Cardiology
Magdalena Restel, Ałła Graban, Grzegorz Witkowski, Danuta Ryglewicz, Halina Sienkiewicz-Jarosz
INTRODUCTION: Bilateral thalamic strokes are rare manifestations of posterior circulation infarcts. Usually the etiology is cardioembolic or small vessel disease combined with individual anatomical predisposition. The symptoms include a variety of neurological deficits depending on thalamic structure involvement, such as paresthesias or numbness, hemiparesis with increased reflexes and Babinski sign, third cranial nerve palsy, speech and cognition disturbance, memory impairment and stupor...
2016: Neurologia i Neurochirurgia Polska
Khalid Jumean, Ahmad Abu Arqoub, Moayad Awni Al Hadidi, Amer Hawatmeh, Hamid Shaaban
The artery of Percheron (AOP) is a rare vascular variant in which a single dominant thalamoperforating artery arises from the P1 segment and bifurcates to supply both paramedian thalami. Occlusion of this uncommon vessel results in a characteristic pattern of bilateral paramedian thalamic infarcts with or without mesencephalic infarctions. We report a case of a 37-year-old man with acute bilateral thalamic infarcts. The scans revealed symmetric bilateral hyperintense paramedian thalamic lesions consistent with an acute ischemic event...
January 2016: Journal of Natural Science, Biology, and Medicine
Masashi Nakadate, Norikazu Miyamoto, Jay Starkey, Akira Toriihara, Ukihide Tateishi
I-FP-CIT SPECT is widely used for diagnosis in patients with parkinsonism. Vascular parkinsonism usually has nonspecific findings from normal uptake to radiotracer decrease in the infarcted region. Infarction of the substantia nigra has been reported as a rare cause of vascular parkinsonism. We present a case of artery of Percheron infarction involving the substantia nigra unilaterally with ipsilateral reduction of striatal uptake on I-FP-CIT SPECT, suggesting anterograde degeneration of the nigrostriatal pathway...
June 2016: Clinical Nuclear Medicine
James Bailey, Kayvan Khadjooi
Bilateral paramedian thalamic infarction resulting from artery of Percheron occlusion presents with a distinct clinical syndrome comprising impaired consciousness, often with vertical gaze palsy and memory impairment. This uncommon anatomical variant arises as a single artery supplying both paramedian thalami. Early recognition can be challenging in the obtunded patient, where the differential diagnosis is broad. The acute physician should consider this diagnosis in a patient presenting with unexplained coma so that emergent treatments such as thrombolysis can be employed...
February 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
Giovanna Viticchi, Lorenzo Falsetti, Chiara Fiori, Giorgia Jorio, Andrea Plutino, Laura Buratti, Marco Bartolini, Mauro Silvestrini
OBJECTIVES: The Percheron artery (PA) is a rare variant vessel. Its acute occlusion can cause a bilateral symmetrical thalamic stroke, clinically manifested as a sudden alteration of consciousness that could vary from sleepiness to coma. In this paper, we illustrate a case of acute PA occlusion in a young, pregnant woman and present a review of the literature, focusing on the possible causes of the acute occlusion. METHODS: A 35-year-old woman, at the fourth week of pregnancy, came to the emergency department of our hospital because of a sudden onset and persistent loss of consciousness...
March 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Yongxing Zhou, Derrick Fox, Abhishek Anand, Amal Elhaj, Arushi Kapoor, Faranak Najibi, Han Kim, Roger Weir, Annapurni Jayam-Trouth
The Korsakoff syndrome is defined as "an abnormal mental state in which memory and learning are affected out of all proportion to other cognitive functions in an otherwise alert and responsive patient." Confabulation refers to false or erroneous memories arising, not deliberately, in the context of a neurological amnesia and is often thought of as pathognomonic of the Korsakoff syndrome. Although the exact pathophysiology is unknown, various studies have identified brain lesions in the thalami, mammillary bodies, and frontal cortex...
2015: Case Reports in Neurological Medicine
Madiha Mahfoudhi, Sami Turki
No abstract text is available yet for this article.
2015: Pan African Medical Journal
Maximiliano A Hawkes, Julieta E Arena, Cecilia Rollán, Virginia A Pujol-Lereis, Carlos Romero, Sebastián F Ameriso
INTRODUCTION: Rarely, both paramedian thalami receive arterial blood flow from a single unilateral vessel arising from the first segment of 1 posterior cerebral artery. This artery has received the name of artery of Percheron (AP). There is no consensus regarding the true prevalence of this anatomical variant. Bilateral paramedian thalamic infarcts are uncommon (0.1% to 2% of ischemic strokes). The main cause is the occlusion of the AP due to cardioembolism. Diffusion-weighted magnetic resonance imaging demonstrates the lesion in the acute setting...
November 2015: Neurologist
D Bengel, T Staudacher, C Rückert, N Prey, A Bernhard
No abstract text is available yet for this article.
December 2015: Der Nervenarzt
Muhammad Almamun, Appu Suman, Syed Arshad, Sonni Jayathirthachar Sanjeev Kumar
Blood supply to the thalamus and brainstem have frequent anatomic variations. One of these is where all the perforators to the above areas arise from a single branch of the posterior cerebral artery commonly known as the artery of Percheron. Infarction involving this artery leading to bilateral thalamic and midbrain lesions is not uncommon, but can cause diagnostic difficulties due to the varying clinical presentations possible and the wide differentials. Early brain imaging and diagnosis is important for initiating appropriate treatment...
2015: Journal of Clinical Medicine
Sanjith Aaron, Sunithi Mani, A T Prabhakar, K Karthik, Anil Kumar B Patil, P Suresh Babu, Mathew Alexander
BACKGROUND: Strokes caused by normal variants of the cerebral circulation can be difficult to diagnose, hence a high index of suspicion is needed. This case series discusses the clinical and radiological aspects of one such stroke caused by occlusion of the artery of Percheron (AOP). MATERIALS AND METHODS: Computerized discharge summaries, outpatient records and imaging from picture archiving and communication system (PACS, GE), of patients with AOP infarction over a period of 12-years (2002-2014) were identified and their clinical and radiological features analyzed...
July 2015: Neurology India
H Dechamps, P Gillardin, R De Potter, D Dewilde, M Lemmerling
No abstract text is available yet for this article.
January 2015: JBR-BTR: Organe de la Société Royale Belge de Radiologie (SRBR)
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