Hospital: Complejo Hospitalario de Jaén, Hospital San Cecilio.
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Aut@r o Autores: C. Martinez Huertas, C. Ortiz Pegalajar, A. Milena Muñoz, J. Miras Ventura, J. Martin Molina.,
Presentación:
A 81 year-old women with history of high blood pressure, atrial fibrillation and mitral prosthesis due to rheumatic valvulopathy, was brought to Emergency Service with a decreased level of consciousness and a bilateral mydriasis. The urgent brain CT showed a bilateral soft hypoattenuating areas in both thalamus, so the study was completed with a MRI which demonstrated bilateral and symmetric hyperintense areas, in FLAIR and T2 sequences, with restricted diffusion in paramedian thalamus.
Discusión:
These findings confirmed the presence of bilateral isquemic stroke of thalamus, due to an occlusion of Percheron artery. The artery of Percheron is a rare anatomical variant of posterior circulation, where a single thalamic perforating artery arises from the proximal posterior cerebral artery (P1 segment) between the basilar artery and the posterior communicating artery, and supplies the rostral mesencephalon and both paramedian territories of the thalami, therefore its occlusion, in our case due to a cardiac embolism, results in a bilateral and symmetric thalamic stroke with a characteristic distribution, with or without mesencephalic involvement, that manifests itself with altered consciousness (including coma), vertical gaze paresis and cognitive disturbance (1).
Conclusión:
These findings confirmed the presence of bilateral isquemic stroke of thalamus, due to an occlusion of Percheron artery. The artery of Percheron is a rare anatomical variant of posterior circulation, where a single thalamic perforating artery arises from the proximal posterior cerebral artery (P1 segment) between the basilar artery and the posterior communicating artery, and supplies the rostral mesencephalon and both paramedian territories of the thalami, therefore its occlusion, in our case due to a cardiac embolism, results in a bilateral and symmetric thalamic stroke with a characteristic distribution, with or without mesencephalic involvement, that manifests itself with altered consciousness (including coma), vertical gaze paresis and cognitive disturbance (1).
Bibliografía:
– Caruso P, Manganotti P, Moretti R. Complex neurological symptoms in bilateral thalamic stroke due to Percheron artery occlusion. Vascular Health and Risk Management, 2017,13: 11–14. – Vinod K.V, Kaaviy R, Arpita B. Artery of Percheron Infarction. An