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Colegio de Medicina Interna de México.
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2018, Number 1

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Med Int Mex 2018; 34 (1)

Bilateral thalamic infarct secondary to Percheron’s artery occlusion.

Galnares-Olalde JA, León-Mayorga Y, Halabe-Cherem J, Rubalcava-Ortega J, Alegría-Loyola MA
Full text How to cite this article

Language: Spanish
References: 9
Page: 157-161
PDF size: 376.23 Kb.


Key words:

Posterior cerebral artery, Thalamic infarcts, Stroke.

ABSTRACT

The Percheron’s artery is a vascular variant characterized by the presence of a dominant thalamic-perforating artery originated in the P1 segment of the posterior cerebral artery; it forks to irrigate both thalamus in its paramedial portion. Its obstruction results in bilateral thalamic infarcts in the paramedial site. This paper reports the case of an 85-year-old man evaluated for alterations in the state of consciousness, associated with little interaction with the environment and vertical paralysis of the gaze. MRI evidenced bilateral thalamic stroke. The presentation of bilateral thalamic lesions is rare. The thalamic infarcts represent 11% of the vascular events, and the bilateral events 22 to 35% of the thalamic vascular events; they usually have an embolic origin and they are rarely associated with hypoperfusion. The typical triad includes alterations of the state of consciousness, alterations of the memory and vertical paralysis of the gaze. Although this is an infrequent disease, it is important to consider the performance of imaging studies in patients with alterations of the state of consciousness that allow to discard thalamic infarctions as part of the differential diagnosis.


REFERENCES

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  2. Krampla W, Schmidbauer B, Hruby W. Ischaemic stroke of the artery of Percheron. Eur Radiol 2008;18:192-194.

  3. Schmahmann J. Vascular syndromes of the thalamus. Stroke 2003;34(9):2264-2278.

  4. Cassourret G, Prunet B, Sbardella F, Bordes J, et al. Ischemic stroke of the artery of Percheron with normal initial MRI: A case report. Case Report Med 2010;2010:425734.

  5. Khanna PC, Iyer RS, Chaturvedi A, Thapa MM, Chaturvedi A, Ishak GE, Shaw DW. Imaging bithalamic pathology in the pediatric brain: demystifying a diagnostic conundrum. Am J Roentgenol 2011 Dec;197(6):1449-59.

  6. Teoh HL, Ahmad A, Yeo LL, Hsu E, Chan BP, Sharma VK. Bilateral thalamic infarctions due to occlusion of artery of Percheron. J Neurological Sci 2010 Jun 15;293(1-2):110-1.

  7. Guy E, Lee J. Bilateral thalamic infarcts due to occlusion of the Artery of Percheron and discussion of the differential diagnosis of bilateral thalamic lesions. J Radiol Case Rep 2013 Jul; 7(7):7-14.

  8. Vela S, Sanchez A. Síndrome de Percheron: lesiones talámicas bilaterales. Sanid Militar 2014;70(1):30-32.

  9. Percheron G. Arteries of the human thalamus: II. Arteries and paramedian thalamic territory of the communicating basilar artery. Rev Neurol 1976;132(5):309-324.




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Med Int Mex. 2018;34