Purpose: Occlusion of the artery of Percheron (AOP), a rare vascular variant of basilar artery branch, is presumed to cause bilateral paramedian thalamic infarction. We present a case of acute AOP infarction with status epilepticus.
Case Report: A 65-year-old woman had past history of hypertension, type 2 diabetes mellitus, and major depressive disorder. She was found to have altered mental status on awakening. She developed tonic convulsion and progressed to status epilepticus later. The brain magnetic resonance imaging (MRI) showed acute bilateral paramedian thalamic and interpeduncular mesencephalic infarction. The electroencephalography (EEG) showed continuous epileptiform discharges. After receiving antiplatelet and anticonvulsant agents, she regained her level of consciousness and has completely recovered to previous baseline.
Conclusions: To our knowledge, this is the first case of AOP infarction presenting status epilepticus. Early recognition and treatment of seizure may reverse altered mental status in those patients.
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Cureus
December 2024
Department of Neurosurgery, Southmead Hospital, North Bristol NHS Trust, Bristol, GBR.
The occipital sinus is often thought of as a redundant vestigial structure in adults. However, in rare cases, it can form the dominant route of intracerebral venous drainage, with a risk of significant surgical morbidity if unrecognised. We present an illustrative case describing this anatomical variant and tailoring of a midline suboccipital craniotomy to allow resection of a fourth ventricular epidermoid tumour with preservation of a dominant occipital sinus, and a review of the published literature.
View Article and Find Full Text PDFNeurol India
November 2024
Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India.
Stroke is a major public health concern and leads to significant disability. Bilateral thalamic infarcts are rare and can result in severe and chronic cognitive and behavioral disturbances-apathy, personality change, executive dysfunctions, and anterograde amnesia. There is a paucity of literature on neuropsychological rehabilitation in patients with bilateral thalamic infarcts.
View Article and Find Full Text PDFNeurointervention
December 2024
Department of Neuroradiology, Neuroscience Institute, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar.
J Nippon Med Sch
November 2024
Department of Pediatrics, Nippon Medical School Chiba Hokusoh Hospital.
The artery of Percheron (AOP), a common anatomic vascular variation of the P1 segment of the posterior cerebral artery, provides arterial blood supply to the paramedian thalami and rostral midbrain. Occlusion of the AOP can lead to infarction of the bilateral paramedian thalamus, with or without midbrain involvement, but is rare in children. Here, we describe a case involving a 14-year-old girl with sudden onset of disturbance of consciousness, hypersomnia, and global aphasia.
View Article and Find Full Text PDFInterv Pain Med
September 2024
Jordan Young Institute, Virginia Beach, VA, USA.
This series of FactFinders presents a brief summary of the evidence and outlines recommendations to minimize risks associated with cervical epidural injections. Evidence in support of the following facts is presented. - 1) CILESIs should be performed at C6-C7 or below, with C7-T1 as the preferred access point due to the more generous dorsal epidural space at this level compared to the more cephalad interlaminar segments.
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