[Bilateral paramedian thalamic infraction due artery of Percheron occlusion]

Artery of Percheron (AOP) is an anatomical variant responsible for the bilateral irrigation of both the medial thalami and rostral sector of the brainstem. Its obstruction causes infarcts in these areas.

To describe a clinical case of AOP infarction, highlighting the clinical and imaging fin dings to consider this pathology in the pediatric population with acute altered state of consciousness.

A healthy 17-year-old adolescent presented with altered state of consciousness and diplopia, which was resolved in a few hours. Brain MRI showed a bilateral medial thalamic infarction, diagnosing an occlusion of the AOP. The only presumed etiological element was the presence of a patent foramen ovale. Surgical correction of the cardiac defect and anticoagulation were performed, with complete recovery.

It is essential to know the clinical-radiological pattern of this condition, which is very characteristic, but infrequent in the pediatric age.