Artery of Percheron infarction

Discussion:

This patient's embolus was presumably from identified left ventricular thrombus.

The thalamus is supplied by multiple small vessels originating from the Posterior communicating arteries and P1 and P2 segments of the posterior cerebral arteries. The artery of Percheron is a normal variant, it is characterized with single arterial trunk arising from posterior cerebral artery and supplies to bilateral paramedian thalami and rostral midbrain 1.

Occlusion of an artery of Percheron leads to bilateral paramedian thalamic infarcts with or without midbrain involvement 1.

Differential diagnoses include 1:

  1. Top of the basilar artery syndrome.
  2. Bilateral internal cerebral venous thrombosis and
  3. Bilateral thalamic glioma
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