Lesson of the month 1: Artery of Percheron occlusion - an -uncommon cause of coma in a middle-aged man

Clinical Medicine : Journal of the Royal College of Physicians of London
James Bailey, Kayvan Khadjooi

Abstract

Bilateral paramedian thalamic infarction resulting from artery of Percheron occlusion presents with a distinct clinical syndrome comprising impaired consciousness, often with vertical gaze palsy and memory impairment. This uncommon anatomical variant arises as a single artery supplying both paramedian thalami. Early recognition can be challenging in the obtunded patient, where the differential diagnosis is broad. The acute physician should consider this diagnosis in a patient presenting with unexplained coma so that emergent treatments such as thrombolysis can be employed. Early imaging with computerised tomography can often be normal; therefore the use of magnetic resonance imaging is essential in confirming the diagnosis.

References

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Feb 28, 2007·RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin·J LinnH Brückmann
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May 1, 2015·BMC Anesthesiology·Marlene Wb B HorstingDylan W de Lange

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Citations

Jul 4, 2020·American Journal of Men's Health·Imen Ben SaidaMohamed Boussarsar

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