Artery of Percheron (AOP) infarction is a rare but clinically important cause of unilateral or bilateral thalamic infarction, commonly with a heterogeneous presentation and nonspecific neurological symptoms. In contrast to unilateral thalamic strokes, AOP infarction can present a unique hurdle for diagnostic considerations owing to its atypical clinical manifestation and the lack of widespread knowledge of this anatomic variant among clinicians. AOP infarction is associated with potentially better outcomes if it is diagnosed early, as timely and appropriate interventions can greatly affect the outcome. This case of a 39-year-old Indian female emphasizes the necessity of taking AOP infarction into account in the differential diagnosis of patients with acute symptoms of central nervous system dysfunction, particularly when initial imaging is nondiagnostic or when clinical features such as altered mental status, visual disturbances, or cognitive impairment are present. This highlights the challenges encountered in diagnosing and treating the condition while also necessitating a thorough history-taking and study of symptomatology. Early diagnosis, the use of appropriate imaging techniques, and timely treatment help increase the chances of good functional outcomes and reduce long-term neurological deficits, highlighting the need for multidisciplinary care.
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http://dx.doi.org/10.7759/cureus.78378 | DOI Listing |
Neuroradiology
March 2025
East Sussex Healthcare NHS Trust, Saint Leonards-on-Sea, UK.
Background And Purpose: The Artery of Percheron (AoP) supplying bilateral paramedian thalami and rostral midbrain is a rare anatomical variant. In the event of occlusion of AoP, a characteristic pattern of ischaemia is seen, presenting as bithalamic signal abnormality on magnetic resonance imaging (MRI). However, this particular imaging finding has significant radiological and clinical overlap with other conditions, necessitating a comprehensive understanding of the imaging characteristics and potential differential diagnosis.
View Article and Find Full Text PDFCureus
February 2025
General Practice, Royal Cornwall Hospital, Cornwall, GBR.
Artery of Percheron (AOP) infarction is a rare but clinically important cause of unilateral or bilateral thalamic infarction, commonly with a heterogeneous presentation and nonspecific neurological symptoms. In contrast to unilateral thalamic strokes, AOP infarction can present a unique hurdle for diagnostic considerations owing to its atypical clinical manifestation and the lack of widespread knowledge of this anatomic variant among clinicians. AOP infarction is associated with potentially better outcomes if it is diagnosed early, as timely and appropriate interventions can greatly affect the outcome.
View Article and Find Full Text PDFCureus
January 2025
Department of Neurology, Hassan II University Teaching Hospital, Fez, MAR.
The artery of Percheron (AOP) is a rare vascular variant that can cause bilateral paramedian thalamic infarctions when occluded. Due to its atypical clinical presentation and subtle imaging findings, this condition often leads to significant diagnostic challenges. The timely recognition of this condition is critical to implementing appropriate management strategies and improving patient outcomes.
View Article and Find Full Text PDFMed Klin Intensivmed Notfmed
January 2025
Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Deutschland.
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.
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