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Related Experiment Videos

Stuck with a drowsy patient, evoke the Percheron.

Sanjith Aaron, Sunithi Mani, A T Prabhakar

  • 1Department of Neurological Sciences, Neurology Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.

Neurology India
|August 5, 2015
PubMed
Summary

Strokes from the artery of Percheron (AOP) are rare but serious. Magnetic resonance imaging (MRI) is crucial for diagnosing these thalamic infarcts, often presenting with consciousness disorders.

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Area of Science:

  • Neurology
  • Radiology
  • Vascular Neurology

Background:

  • Cerebral circulation variants can cause difficult-to-diagnose strokes.
  • A high index of suspicion is necessary for rare stroke types.
  • This series focuses on artery of Percheron (AOP) occlusion strokes.

Purpose of the Study:

  • To analyze the clinical and radiological features of artery of Percheron (AOP) infarction.
  • To highlight the diagnostic challenges and imaging characteristics of AOP strokes.
  • To identify common etiological factors and outcomes in AOP infarction.

Main Methods:

  • Retrospective analysis of 17 patients with AOP infarction from 2002-2014.
  • Review of computerized discharge summaries, outpatient records, and PACS imaging.

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  • Correlation of clinical presentation, MRI findings, and etiological factors (TOAST criteria).

    • Main Results:

    • AOP infarction accounted for 0.47% of all strokes (17/3589).
    • Common symptoms included disorders of consciousness (94%), gaze (53%), and memory impairment (24%).
    • MRI revealed bilateral paramedian thalamic infarcts in all patients; CT was less sensitive (55%).
    • Cardioembolic (47%) and small vessel occlusion (41%) were primary causes.
    • Mortality was 12%, with 47% achieving a modified Rankin score ≤2 at 6 months.

    Conclusions:

    • Artery of Percheron infarcts are a critical differential diagnosis for altered consciousness.
    • Magnetic resonance imaging (MRI) is the preferred diagnostic modality.
    • Active investigation for embolic sources is recommended.