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Artery of Percheron

Aun Raza Shah, Rubab Ali
A 39 year old male was found unconscious at home. On arrival to the hospital the patient was profoundly somnolent but easily rousable, with no focal neurological deficits. Imaging confirmed bilateral thalamic infarcts from the occlusion of Artery of Percheron, a rare anatomic variant which is a single arterial trunk supplying the thalamus and midbrain bilaterally. Anti-platelet therapy was initiated as soon as the diagnosis was established and the patient showed a rapid remarkable recovery over the next 48 hours...
January 2018: JPMA. the Journal of the Pakistan Medical Association
Zhihua Xu, Lingling Sun, Yang Duan, Jinghua Zhang, Mengzhi Zhang, Xiaonan Cai
OBJECTIVE: To assess the imaging and clinical features of patients with an artery of Percheron infarction comprehensively. METHODS: Of 6539 patients with a first-ever stroke, 18 patients with a Percheron infarction were enrolled, and their images and clinical data were retrospectively investigated. RESULTS: All patients underwent neurological intensive care unit (NICU) management. The initial symptom of a Percheron infarction included dizziness, transient blurred vision, double vision, barylalia, cerebellar ataxia, drowsiness, and a coma...
December 15, 2017: Journal of the Neurological Sciences
Jacopo C DiFrancesco
No abstract text is available yet for this article.
December 2, 2017: BMJ Case Reports
Tz-Shiang Wei, Chun-Sheng Hsu, Yu-Chun Lee, Shin-Tsu Chang
RATIONALE: Holmes' tremor is an uncommon neurologic disorder following brain insults, and its pathogenesis is undefined. The interruption of the dento-rubro-thalamic tract and secondary deterioration of the nigrostriatal pathway are both required to initiate Holmes' tremor. We used nuclear medicine imaging tools to analyze a patient with concurrent infarction in different zones of each side of the thalamus. Finding whether the paramedian nuclear groups of the thalamus were injured was a decisive element for developing Holmes' tremor...
November 2017: Medicine (Baltimore)
Léonard Kouamé Kouassi, Mariam Doumbia-Ouattara
BACKGROUND Bi-thalamic infarctions are rare and marked by clinical polymorphism. Their association with HIV has never been reported. CASE REPORT We report a 51-year-old right-handed man with no medical history, who presented an acute onset vascular dementia associated with an antero-retrograde amnesia, a word-finding difficulty, and a dysexecutive syndrome. The CT scan was normal. Brain MRI revealed a paramedian and bi-thalamic infarction, evoking an occlusion of the Percheron artery. The electrocardiogram, transthoracic and transesophageal cardiac ultrasound, and Doppler echo of cervical arteries gave normal results...
October 27, 2017: American Journal of Case Reports
Matthew Sechler, Jasmeet Singh, Nada El Husseini
No abstract text is available yet for this article.
October 17, 2017: Neurology
Farheen Niazi, Sameen Bin Naeem
Artery of Percheron (AOP) is a rare vascular variant of posterior cerebral circulation and it supplies blood to the bilateral paramedian thalami and the rostral midbrain. Artery of Percheron infarct requires a comprehensive clinical and radiological examination. It can be easily overlooked due to normal CTfindings and wide range of differential diagnosis. Classic triad of presentation is altered mental status, memory impairment and the vertical gaze palsy. We report a case of a 66-year female who had sudden onset of severe vertigo, diplopia and ataxia...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Axel Sandvig, Sandra Lundberg, Jiri Neuwirth
BACKGROUND: The artery of Percheron is a rare anatomic variant of arterial supply to the paramedian thalamus and rostral midbrain, and occlusion of the artery of Percheron results in bilateral paramedian thalamic infarcts with or without midbrain involvement. Acute artery of Percheron infarcts represent 0.1 to 2% of total ischemic stroke. However, of thalamic strokes, occlusion of artery of Percheron is the cause in 4 to 35% of cases. Early diagnosis of artery of Percheron infarction can be challenging because it is infrequent and early computed tomography or magnetic resonance imaging may be negative...
August 12, 2017: Journal of Medical Case Reports
Amey Beedkar, Archana Sonawale
The artery of Percheron uncommon anatomic variant that provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions. The clinical diagnosis is difficult because of the large clinical variability. We report the clinical and MR imaging findings in a patient who developed infarction in the typical distribution of the artery of Percheron.
August 2017: Journal of the Association of Physicians of India
Adam MacLellan, Karl Boyle
OBJECTIVE: We aimed to report a novel case of hyperacute computed tomography (CT) perfusion imaging abnormalities in artery of Percheron infarction. METHODS: We described a case of a 74-year-old man who presented acutely to the emergency room with witnessed sudden onset altered level of consciousness. RESULTS: Although initial hyperacute CT brain imaging was reported as normal, subsequent magnetic resonance imaging revealed bilateral paramedian thalamic infarction...
June 7, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Dhaval Shukla
No abstract text is available yet for this article.
October 2017: British Journal of Neurosurgery
Pushpa Raj Puri, Astha Sijapati
The artery of Percheron (AOP) infarction always manifests as paramedian bilateral thalamic infarcts and might present as paramedian midbrain infarcts. Despite the limited MRA evaluation, due to small size of the artery, careful evaluation of the patient's history, the clinical presentation with imaging findings can facilitate the proper diagnosis.
March 2017: Clinical Case Reports
Paola Caruso, Paolo Manganotti, Rita Moretti
The artery of Percheron is a rare anatomical variant where a single thalamic perforating artery arises from the proximal posterior cerebral artery (P1 segment) between the basilar artery and the posterior communicating artery and supplies the rostral mesencephalon and both paramedian territories of the thalami. Almost one-third of human brains present this variant. Occlusion of the artery of Percheron mostly results in a bilateral medial thalamic infarction, which usually manifests with altered consciousness (including coma), vertical gaze paresis, and cognitive disturbance...
2017: Vascular Health and Risk Management
Daniel Hammersley, Ankur Arora, Madhava Dissanayake, Nabarun Sengupta
An 81-year-old man underwent cardiac catheterisation to investigate breathlessness and left ventricular impairment of unknown cause. He had unobstructed coronary arteries. Immediately following the procedure, he became suddenly unresponsive with vertical gaze palsy, anisocoria and bilateral upgoing plantar responses. He made a rapid recovery to his premorbid state 25 min later with no residual focal neurological signs. He then had multiple unresponsive episodes, interspaced with complete resolution of symptoms and neurological signs...
January 2, 2017: BMJ Case Reports
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
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