Artery of Percheron (AOP) occlusion is a rare cause of ischemic stroke characterized by bilateral paramedian thalamic infarcts, with or without mesencephalic infarction. Clinically it presents with mental state disturbances, hypersomnolence, aphasia/dysarthria, amnesia and ocular movement disorders, including vertical gaze palsy. Here, we report a case of cardioembolic AOP infarction in a 37-year-old woman with rheumatic mitral valvular stenosis. This case is being reported to highlight the interesting clinical and neuroimaging features of this rare condition, and the differential diagnosis of AOP infarction on imaging have been discussed.
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http://dx.doi.org/10.1159/000443570 | DOI Listing |
Stroke
January 2025
Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China (H.L., J.Z.).
Cureus
November 2024
Neurology, Dalhousie University, Halifax, CAN.
This case report discusses a unique presentation of an artery of Percheron (AOP) infarct resulting in rapidly resolving internuclear ophthalmoplegia (INO) without classical signs. This is the case of a 70-year-old male patient who presented to a community Emergency Department following acute code stroke activation. Physical exam and imaging studies including non-contrast CT, CT angiography, CT perfusion, and MRI were performed.
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Department of Neurology, Shaoxing Second Hospital, Shaoxing, Zhejiang, China.
Rationale: Bilateral thalamic infarction is a rare type of posterior circulation stroke, and it often presents with a reduced level of consciousness in the elderly. Arteriosclerosis is the primary etiology of bilateral thalamic infarction, including conditions such as native vessel stenosis or arterial-to-arterial embolism. Cardiogenic or paradoxical embolism can also lead to thrombosis of the perforator branches innervating the thalamus, and these emboli tend to disintegrate and lead to multiple lesions, even in elderly patients.
View Article and Find Full Text PDFNeurocase
October 2024
Faculté de médecine et de pharmacie de Casablanca, Université Hassan II de Casablanca, Casablanca, MA, Morocco.
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.
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