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Artery of Percheron

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.
March 10, 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
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
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