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Case Reports
. 2023 Nov 2;15(4):1352-1358.
doi: 10.3390/neurolint15040085.

A Case Series of Four Patients with Artery of Percheron Occlusion over a Three-Month Period

Matej Perovnik  1   2 , Janja Pretnar Oblak  1   2 , Senta Frol  1   2
Affiliations
Case Reports

A Case Series of Four Patients with Artery of Percheron Occlusion over a Three-Month Period

Matej Perovnik et al. Neurol Int. .

Abstract

Here, we present a case series of four patients diagnosed with acute ischaemic stroke due to occlusion of the artery of Percheron (AOP), a rare stroke variant, observed in a single emergency centre within a three-month period. AOP occlusion is characterized by bilateral thalamic infarction with or without involvement of the mesencephalon. The presenting symptoms are diverse and not specific, but commonly include disturbance of consciousness, memory impairment, and vertical gaze palsy. In addition, due to the location of the infarction, imaging recognition is challenging and AOP occlusion often remains undiagnosed. This paper emphasizes the necessity of early recognition and appropriate management of AOP occlusion to significantly impact patient outcomes. Moreover, we argue that the condition might be more common than previously thought and that misdiagnosis or delay in diagnosis may lead to inappropriate treatment and potential failure to apply thrombolysis within the required timeframe.

Keywords: artery of Percheron; case series; incidence; stroke; thalamus.

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Conflict of interest statement

S.F. and J.P.O. received speaker’s honoraria and travel support from Boehringer Ingelheim. Other than that, they have no competing financial interests or personal relationships that could have influenced the work reported in this paper.

Figures

Figure 1
Figure 1
(A) Case 1: head computer tomography (CT) (upper) and CT perfusion (lower) scans two days after initial presentation. (B) Case 2: head CT scans at initial presentation (upper) and one day later (lower). (C) Case 3: head CT scan at initial presentation (upper), magnetic resonance imaging (MRI) diffusion weighted imaging (middle), and fluid attenuated inversion recovery (lower) at initial presentation. (D) Case 4: head CT (upper), MRI diffusion weighted imaging (middle), and fluid attenuated inversion recovery (lower) at initial presentation. White arrows show changes in the thalami.
Figure 2
Figure 2
Schematic depiction of the thalamus and its arterial supply according to the Percheron classification [11] and the estimated population prevalence of each variant [3]. PCA—posterior cerebral artery, BA—basilar artery. Created with BioRender.com (© 2023 BioRender).
See this image and copyright information in PMC

References

    1. Nouh A., Remke J., Ruland S. Ischemic Posterior Circulation Stroke: A Review of Anatomy, Clinical Presentations, Diagnosis, and Current Management. Front. Neurol. 2014;5:30. doi: 10.3389/fneur.2014.00030. - DOI - PMC - PubMed
    1. Arauz A., Patiño-Rodríguez H.M., Vargas-González J.C., Arguelles-Morales N., Silos H., Ruiz-Franco A., Ochoa M.A. Clinical Spectrum of Artery of Percheron Infarct: Clinical–Radiological Correlations. J. Stroke Cerebrovasc. Dis. 2014;23:1083–1088. doi: 10.1016/j.jstrokecerebrovasdis.2013.09.011. - DOI - PubMed
    1. Kocaeli H., Yılmazlar S., Kuytu T., Korfalı E. The artery of Percheron revisited: A cadaveric anatomical study. Acta Neurochir. 2013;155:533–539. doi: 10.1007/s00701-012-1548-1. - DOI - PubMed
    1. Ciacciarelli A., Francalanza I., Giammello F., Galletta K., Toscano A., Musolino R.F., Granata F., La Spina P. Prevalence, clinical features, and radiological pattern of artery of Percheron infarction: A challenging diagnosis. Neurol. Sci. 2023;44:2413–2419. doi: 10.1007/s10072-023-06681-4. - DOI - PubMed
    1. Carrera E., Michel P., Bogousslavsky J. Anteromedian, Central, and Posterolateral Infarcts of the Thalamus. Stroke. 2004;35:2826–2831. doi: 10.1161/01.STR.0000147039.49252.2f. - DOI - PubMed

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