Percheron artery infarction (bilateral thalamic stroke)

Case contributed by Andrei Dumitrescu

Presentation

Thalamic syndrome with paralysis and coma.

Patient Data

Age: 60 years
Gender: Female

Bilateral, nearly symmetrical, sharply delineated hypodensity in the thalamic nuclei.

Case Discussion

This elderly patient became comatose while undergoing PTCA for myocardial infarction. Initial CT and CT angiography were reported as unremarkable.

Follow up CT 3 days later showed sharply delineated, nearly symmetrical hypodensities of both thalamic nuclei, consistent with acute embolic infarctions. Since there was no evidence of thrombus at the top of the basilar artery, the cause for these bilateral thalamic infarctions was assumed to be embolism of the artery of Percheron.

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