Artery of Percheron infarction

Case contributed by Dr Coenraad Hattingh


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

Patient Data

Age: 40 years
Gender: Male

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

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

PlayAdd to Share

Case information

rID: 27975
Published: 3rd Mar 2014
Last edited: 5th Oct 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.