Hyperdense PCA sign and artery of Percheron infarct

Case contributed by Ian Bickle


Left arm tingling sensation and decreased sensation. Found unconscious. Left lateral visual disturbance.

Patient Data

Age: 50 years
Gender: Female

Hyperdense right posterior cerebral artery consistent with intraluminal thrombosis.

No acute infarct or hemorrhage.

Avid diffusion restriction in the territory of the right posterior cerebral artery territory in keeping with a territory infarct.

Acute bilateral thalamic infarcts.  Left cerebellar hemispheric acute infarct.

Established left cerebellar hemispheric infarct.

Case Discussion

Two interest aspects to this case.

1.  A hyperdense PCA sign on CT - nearly always observed in the MCA, but rarely in the PCA.

The end organ damage on MRI confirms occlusion of the right posterior cerebral artery.

2.  Artery of Percheron infarct.

The artery of Percheron is a solitary arterial trunk that branches from one of the proximal segments of either posterior cerebral artery (PCA), which in this case must be from the right PCA. 

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