Artery of Percheron Stroke: A Case Report

Area of Science:

• Neurology
• Vascular Neurology
• Neuroimaging

Background:

• The Artery of Percheron (AOP) is a common vascular variant supplying bilateral thalami.
• Occlusion of the AOP can lead to rare but significant bilateral thalamic infarction.
• Clinical presentation includes altered consciousness, gaze abnormalities, and cognitive deficits.

Purpose of the Study:

• To present a case of ischemic stroke due to Artery of Percheron occlusion.
• To highlight the diagnostic challenges and neuroimaging findings in AOP stroke.
• To emphasize the importance of considering AOP infarction in patients with specific neurological symptoms.

Main Methods:

• Case report of a 61-year-old male with alcohol abuse.
• Clinical presentation with sudden loss of consciousness, third nerve palsy, and vertical gaze palsy.
• Diagnostic neuroimaging using Magnetic Resonance Imaging (MRI) to identify bilateral thalamic infarction.

Main Results:

• MRI revealed bilateral paramedian thalamic infarction with midbrain involvement.
• The patient experienced minimal improvement despite conservative treatment, remaining lethargic and dysarthric.
• Discharge to palliative care was recommended due to the severity of neurological deficits.

Conclusions:

• Artery of Percheron infarction, though uncommon, must be considered in patients presenting with altered consciousness.
• Early MRI is critical for accurate diagnosis and timely management of AOP stroke.
• Increased physician awareness of this vascular anomaly and its potential complications is essential.