Bilateral Paramedian Thalamic Syndrome After Infection

Artery of Percheron Stroke as an Unusual Cause of Hypersomnia: A Case Series and a Short Literature Review

“…On May 27, 2020, a personal literature review based on a 2015-2020 PubMed search [key items: "artery of Percheron" AND ("case report" OR "case-series")] found 73 papers published in English language (30, 37, and 6 papers included females, males, and both sexes, respectively). Among the 37 studies including only males, 13 reported sleepiness or equivalent terms (i.e., hypersomnolence, drowsiness, or excessive daytime sleepiness) as a delayed complication of an AOP stroke (Table 1; Afana et al, 2019;Aryan et al, 2016;Bailey & Khadjooi, 2016;Goico & Mikesell, 2018;Harisuthan et al, 2018;Ince & Asan, 2018;Kamasak et al, 2015;Khanni et al, 2018;Oliveira et al, 2018;Shah & Ali, 2018;Vasconcellos et al, 2016;Zelante et al, 2015;Zhou et al, 2015).…”

Reply to Huo et al.

“…In our paper we described two cases of suspected bilateral paramedian thalamic syndrome following infection (1).Gait and speech impairment was present in the first case. That patient's MR images following post-infection cerebellitis suggested ADEM.…”

Transient coma as Percheron’s artery stroke

“…Moreover, Creutzfeldt-Jakob disease, Wernicke encephalopathy, and extrapontine myelinolysis should also be considered in differential diagnosis (13). On the other hand, bilateral medial thalamic lesions, radiographically demonstrated, must be differentiated from several different nonvascular pathologies, such as toxic processes (Wernicke's encephalopathy), metabolic alterations (extrapontine myelinolysis and Wilson's disease), acute necrotizing encephalopathy, neurodegenerative disease (dorsomedian thalamic nucleus involvement in Creutzfeldt-Jacob disease), infections (Epstein-Barr virus encephalopathy), and neoplastic forms (bilateral thalamic glioma) (14). Sometimes, demyelinating pathologies, such as acute disseminated encephalomyelitis, could be suspected (14).…”