Artery of Percheron infarction
Acute presentation: CN VIII fallout and right sided facial parasthesia.
Loading Stack -
0 images remaining
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.
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.
- Bain SE et al: Bilateral paramedian thalamic and mesencephalic infarcts in a newborn due to occlusion of the artery of Percheron. J Child Neurol. 24(2):219-23, 2009
- Koutsouraki E et al: Acute bilateral thalamic infarction as a cause of acute dementia and hypophonia after occlusion of the artery of Percheron. J Neurol Sci. 283(1-2):175-7, 2009
- Monet P et al: [Bithalamic infarct: is there an evocative aspect? Radioclinical study.] Rev Neurol (Paris). 165(2):178-84, 2009
- Rangel-Castilla L et al: Bilateral paramedian thalamic and mesencephalic infarcts after basilar tip aneurysm coiling: role of the artery of Percheron. Neurocirugia (Astur). 20(3):288-93, 2009
- Ben Slamia L et al: Occlusion of the artery of percheron: clinical and neuroimaging correlation. J Neuroradiol. 35(4):244-5, 2008
- García-Casares N et al: [Thalamic dementia secondary to acute bilateral paramedian thalamic infarcts after occlusion of the artery of Percheron.] Rev Neurol. 46(4):210-2, 2008
- Krampla W et al: Ischaemic stroke of the artery of Percheron (2007: 10b). Eur Radiol. 18(1):192-4, 2008
- Kostanian V et al: Artery of Percheron thrombolysis. AJNR Am J Neuroradiol. 28(5):870-1, 2007
- Raphaeli G et al: Acute bilateral paramedian thalamic infarcts after occlusion of the artery of Percheron. Neurology. 66(1):E7, 2006
- Matheus MG et al: Imaging of acute bilateral paramedian thalamic and mesencephalic infarcts. AJNR Am J Neuroradiol. 24(10):2005-8, 2003
- Lepore FE et al: Neuro-ophthalmological findings with neuropathological correlation in bilateral thalamic-mesencephalic infarction. J Clin Neuroophthalmol. 5(4):224-8, 1985