Artery of Percheron Infarct: A Rare Case of Stroke in Pregnancy

Cerebrovascular complications, including strokes, are relatively frequent during pregnancy. Artery of Percheron is an anatomic variant that supplies the paramedian thalamus. Occlusion of this artery results in bilateral thalamic infarction, which manifests clinically with altered mental status. We present the case of a 33-year-old pregnant woman who presented with drowsiness and headache. The patient was at 12 weeks of gestation. She had normal vital signs, including blood pressure, and no focal neurological deficits were noted on physical examination. Magnetic resonance imaging of the brain was performed. The scan demonstrated abnormal high signal intensity in both thalami on T2-weighted images and corresponding restricted diffusion and low apparent diffusion coefficient. Such findings were consistent with the artery of Percheron infarct. The patient received antiplatelet therapy and exhibited gradual improvement. On discharge, the patient had a near-complete resolution of symptoms. Artery of Percheron infarct is a rare type of stroke. Clinicians should be able to recognize its clinical and imaging features.