Presentation
Fainting attacks, left sided weakness.
Patient Data
Two brain lesions noted at:
- medial right thalamus (supplied by thalamoperforating arteries – posterior cerebral artery territory). It shows a central core of spared diffusion restriction with blooming on SWI, tracking till the right ambient cistern, suggestive of a thrombosed feeding artery originating from right posterior cerebral artery
- upper right cerebellar hemisphere – cortical based (superior cerebellar artery territory)
Both lesions show high T2/FLAIR signal, low T1 signal, and evident diffusion restriction, consistent with acute infarctions in the posterior circulation territory.
Two hypodense lesions are noted at:
- medial right thalamus (supplied by thalamoperforating arteries – posterior cerebral artery territory). Minute internal densities are noted
- upper right cerebellar hemisphere – cortical based (superior cerebellar artery territory)
Features of subacute infarctions in the posterior circulation territory.
Case Discussion
Both infarction territories are along the right-sided posterior circulation. Thalamic infarction belongs to posterior cerebral artery territory (posterior circulation). The superior part of the cerebellar hemisphere is a territory of the superior cerebellar artery (posterior circulation).
Further workup for the case is recommended, including carotid Doppler, echocardiography, and coagulation profile.