Artery of Percheron infarction

Case contributed by Dr Coenraad J. Hattingh

Presentation

Acute presentation: CN VIII fallout and right sided facial parasthesia.

Patient Data

Age: 40
Gender: Male
Modality: MRI

FLAIR hyperintense signal in bilateral paramedian thalami with medial mesencephalic extension. Corresponding restricted diffusion. No enhancement or susceptibility to suggest necrosis yet - which is consistent with the acute presentation. Absence of PCA and SCA involvement confirming artery of Percheron infarction.

Case Discussion

DDx to consider are diffuse glioma, however no asymmetry in the T2 hyperintensity is noted. Lymphoma - no enhancement noted. Top of the basilar - no PCA or SCA involvement. Hypoxic-ischemic-encephalopathy - basal ganglia are unaffected. Deep cerebral venous thrombosis - often accompanied by haemorrhage, which is absent here. Wernicke's encephalopathy - mammillary, hypothalamic and PAG involvement is not seen.

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Case Information

rID: 27975
Case created: 1st Mar 2014
Last edited: 4th Oct 2015
Inclusion in quiz mode: Included

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