Artery of Percheron Occlusion: A Diagnostic Challenge

Ramalho, Carina; Almeida, Mariana; Gomes, Francisco; Silva, Magda; Peixoto, J.; Rodrigues, S. C. P.

doi:10.12890/2021_003020

Cited by 4 publications

(5 citation statements)

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“…This anatomical variant occurs in 4%–11% of the population and infarcts of this artery account for 4%–18% of all thalamic infarcts and 0.1%–2% of all strokes. 1 , 7 , 8 Macedo et al who had one of the most representative series found a frequency of 0.17%. 9 The classic clinical presentation of Percheron artery infarction is a triad of altered consciousness, vertical gaze paralysis, and memory disorders.…”

Section: Discussionmentioning

confidence: 98%

“…Our patient presented with a motor deficit associated with a stupor‐like consciousness disorder. This anatomical variant occurs in 4%–11% of the population and infarcts of this artery account for 4%–18% of all thalamic infarcts and 0.1%–2% of all strokes 1,7,8 . Macedo et al who had one of the most representative series found a frequency of 0.17% 9 .…”

Section: Discussionmentioning

confidence: 99%

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Weber's syndrome revealing a Percheron artery infarction: A case report

Mbodji

Faye

Diop

et al. 2023

Clinical Case Reports

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Key Clinical Message Weber's syndrome revealing a Percheron artery infarction is a rare clinical occurrence. Its diagnosis requires careful clinical examination and brain MRI, which is the gold standard for diagnosis. If this is not available, combined cerebral CT scan with a CT angiography of supra‐aortic arteries may be useful for the diagnosis. Abstract Percheron's artery (PA) occlusion is an uncommon type of stroke involving paramedian thalamus and/or midbrain infarction. It accounts for 4%–18% of all thalamic infarcts and 0.1%–2% of all strokes. Its clinical manifestations are variable and its mode of presentation as Weber's syndrome is exceptional due to the unusual clinical presentation.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Weber's syndrome revealing a Percheron artery infarction: A case report

Mbodji

Faye

Diop

et al. 2023

Clinical Case Reports

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“…The mesencephalothalamic or thalamopeduncular syndrome included movement disorders, hemiplegia and cerebellar ataxia occurs in patients with BPTRMI is related to midbrain involvement [ 28 ]. The superior mesencephalic or rubral artery branch separately from P1 segment of the PCA or share a common origin with AOP, which supply blood to the interpeduncular nucleus, medial part of the red nucleus, nucleus of cranial nerve III and anterior part of the periaqueductal gray matter located in dorsal midbrain [ 29 ]. Similar to polar artery, a single AOP may result in BPTRMI, rather than synchronous occlusions of an AOP and the superior mesencephalic or rubral artery.…”

Section: Discussionmentioning

confidence: 99%

Acute percheron infarction: a precision learning

Zhang

Wang²,

Chen

et al. 2022

BMC Neurol

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Background So far, the diagnosis of acute artery of percheron (AOP) infarction is uncommon. In this study, patients with acute AOP infarction were studied to explore the relationship of imaging findings, clinical manifestations and prognosis of acute AOP infarction. Materials A total of 23 patients with acute AOP infarction in our institution from 2014 to 2019 were reviewed retrospectively. All cases were evaluated by computed tomography (CT) and magnetic resonance imaging (MRI). The modified Rankin scale (MRS), blood examination, electrocardiogram and transthoracic echocardiography were used for detailed clinical and prognostic evaluation. All standard risk factors for these patients were recorded. The MRS scores were performed 90 days after discharge. Results Four different types of acute AOP infarction were identified: (a) bilateral paramedian thalamic infarction (BPTI, 52%); (b) bilateral paramedian thalamic with rostral midbrain infarction (BPTRMI, 30%), (c) bilateral paramedian and anterior thalamic infarction (BPATI, 13%), and (d) bilateral paramedian thalamic with red nuclei infarction (BPTRNI, 4%). These patients had consciousness disorder, memory dysfunctions, vertical gaze paresis and mesencephalothalamic syndrome. The 65% of patients with BPTI and BPATI experienced relatively good functional recovery and could carry out daily life activities (MRS score ≤ 2). However, patients with BPTRMI may have an unfavorable outcome. Conclusions Although the clinical features are variable, DWI or ADC map can improve the diagnosis of acute AOP infarction patterns. Acute AOP occlusion requires immediate diagnosis and treatment to obtain more favorable outcome and avoid additional unnecessary procedures.

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“…Artery of Percheron (AP) infarction is an infrequent type of ischemic stroke involving bilateral paramedian thalami. [ 1 , 2 ] It is responsible for 4–18% of all thalamic infarctions [ 1 ] and 0.1–2% of all cerebral strokes [ 1 , 2 ] and can have a variable clinical presentation as detailed below.…”

mentioning

confidence: 99%

“…Various authors [ 1 , 8 , 9 ] have stressed that AP infarctions can have varied clinical presentations though the three main symptoms are upward gaze palsy, memory disturbances, and altered sensorium [ 9 ] and Khanni et al . [ 8 ] state that as the classical signs of stroke are absent, these patients are usually diagnosed outside the window for thrombolysis.…”

mentioning

confidence: 99%