Artery of Percheron Infarction: Diagnostic and Clinical Insights From Two Cases

Artery of Percheron (AOP) infarction is a rare cause of bilateral paramedian thalamic and rostral midbrain stroke, typically presenting with altered consciousness, vertical gaze palsy, memory deficits, and other nonspecific neurological symptoms. Diagnosis is often delayed due to its variable clinical presentation and the limited sensitivity of initial CT imaging. We report two cases of AOP infarction confirmed by magnetic resonance imaging (MRI), both presenting with reduced responsiveness and requiring intensive care management. MRI revealed bilateral paramedian thalamic infarcts consistent with AOP territory involvement. These cases emphasize the need for early clinical suspicion and prompt MRI evaluation in patients with unexplained altered sensorium.