Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2016 Feb;16(1):86-7.
doi: 10.7861/clinmedicine.16-1-86.

Lesson of the month 1: Artery of Percheron occlusion - an -uncommon cause of coma in a middle-aged man

James Bailey  1 , Kayvan Khadjooi  2
Affiliations
Case Reports

Lesson of the month 1: Artery of Percheron occlusion - an -uncommon cause of coma in a middle-aged man

James Bailey et al. Clin Med (Lond). 2016 Feb.

Abstract

Bilateral paramedian thalamic infarction resulting from artery of Percheron occlusion presents with a distinct clinical syndrome comprising impaired consciousness, often with vertical gaze palsy and memory impairment. This uncommon anatomical variant arises as a single artery supplying both paramedian thalami. Early recognition can be challenging in the obtunded patient, where the differential diagnosis is broad. The acute physician should consider this diagnosis in a patient presenting with unexplained coma so that emergent treatments such as thrombolysis can be employed. Early imaging with computerised tomography can often be normal; therefore the use of magnetic resonance imaging is essential in confirming the diagnosis.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Non-contrast computerised tomography head on admission.
Fig. 2.
Fig. 2.
Magnetic resonance imaging head with diffusion weighted imaging.
See this image and copyright information in PMC

References

    1. Kanich W, Brady WJ, Huff JS, et al. Altered mental status: evaluation and etiology in the ED. Am J Emerg Med 2002;20:613–7. - PubMed
    1. Edlow JA, Rabinstein A, Traub SJ, Wijdicks EF. Diagnosis of reversible causes of coma. Lancet 2014;384:2064–76. - PubMed
    1. Horsting MW, Franken MD, Meulenbelt J, van Klei WA, de Lange DW. The etiology and outcome of non-traumatic coma in critical care: a systematic review. BMC Anesthesiol 2015;15:65. - PMC - PubMed
    1. Zappella N, Merceron S, Nifle C, et al. Artery of Percheron infarction as an unusual cause of coma: three cases and literature review. Neurocrit Care 2014;20:494–501. - PubMed
    1. Merwick A, Werring D. Posterior circulation ischaemic stroke. BMJ 2014;348:g3175. - PubMed

Publication types