Sažetak:Uvod: Bilateralni talamički infarkti su retki i obično udruženi sa tipičnom kliničkom slikom koja, pored ostalog, uključuje i neuropsihološke promene. Prikaz slučaja: Prikazan je slučaj tridesetsedmogodišnje žene sa akutno nastalim diplopijama usled "skew" devijacije, centralnom desnostranom parezom mimične muskulature, levostranom hemihipestezijom, ataksijom, sa očuvanim nivoom svesti i bez ikakvih neuropsiholoških smetnji, izuzev blagog memorijskog deficita. Postavljena je dijagnoza bilateralnog talamičkog infarkta uzrokovanog kardioembolizacijom preko perzistentnog foramena ovale. Zaključak: U slučajevima bilateralnog talamičnog infarkta može se pretpostaviti postojanje retke anatomske varijante talamičke perfuzije poznate kao Percheronova arterija, jedinstvenog stabla koje se grana za irigaciju oba paramedijalne talamičke zone. Uzrok infarkta može biti kardioembolizacija kroz perzistentni foramen ovale, naročito kod mladih ljudi. Naš slučaj prikazuje kombinaciju dva specifična patološka stanja -perzistentnog foramena ovale i bilateralnog talamičkog infarkta. Klinička prezentacija u ovom slučaju je atipična za bilateralni paramedijalni infarkt. Ključne reči: bilateralni talamički infarkt, "skew" devijacija, perzistentni foramen ovale, Percheronova arterija. Summary:Background: Simultaneous bilateral thalamic infarctions are rare and in most cases associated with typical clinical pattern which, beside other things, include neuropsychological changes. Case report: We report a case of a 37-year-old woman with acute onset ofdiplopia from skew deviation, right-sided central facial nerve palsy, left hemihypesthesia, ataxia, with normal level of consciousness and without any neuropsychological disturbances except minor memory deficit. She was diagnosed with bilateral thalamic infarction due to the cardioembolisation via patent foramen ovale. Conclusion: In cases of bilateral thalamic infarction one can presume the existence of rare anatomic variant of thalamic perfusion commonly known as the artery of Percheron, single artery trunk that branches to irrigate both paramedian territories of thalamus. The cause of infarction can be cardioembolism trough the patent foramen ovale, especially in young adults. Our case represents a combination of two specific pathological conditions -patent foramen ovale and bilateral thalamic infarction. Clinical presentation in this case was unusual for the bithalamic paramedian infarction.
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