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Quiz Prize Rules Current Rankings DIAGNOSIS:
Artery of Percheron InfarctThe images show bilateral paramedian thalamic and perimesencephalic hypodensities. This distribution and pattern is highly suggestive of infarction due to involvement of the artery of Percheron.
Artery of Percheron is a single common trunk that arises from one of the P1 segments of the posterior cerebral arteries and supplies the medial aspects of bilateral thalami and the brainstem. Occlusion of this artery results in bilateral and medial thalamic infarcts with a relatively symmetrical distribution and infarction of the rostral mesencephalon.
With bilateral medial thalamic infarcts, “top of the basilar artery syndrome” needs to be considered, however in this latter syndrome the infarctions tend to also involve the territories supplied by the superior cerebellar and PCAs, as well.
From a practical standpoint, these infarcts should be recognized as due to occlusion of a possible single rare artery that is a normal anatomic variant showing its peculiar supply and not be blamed on occlusion of multiple vascular territories or other pathologic conditions such vasculitis or infectious disease.
References:
1.) Matheus, M. Gisele, Castillo, Mauricio
Imaging of Acute Bilateral Paramedian Thalamic and Mesencephalic Infarcts AJNR Am J Neuroradiol 2003 24: 2005-20082.) V. Kostanian and S.C. Cramer.
Artery of Percheron Thrombolysis. AJNR Am. J. Neuroradiol., May 1, 2007 ; 28(5): 870 - 871.3.) Percheron G.
The anatomy of the arterial supply of the human thalamus and its use for the interpretation of the thalamic vascular pathology. Z Neurol1973; 205 :1 –13Disclaimer: No editorial attempt has been made to check the discussion. Any copyright violation or plagiarism by the authors, is directly and entirely the responsibility of the author(s). REF, www.refindia.net and its trustees will not be liable for any issues that arise as a result of the authors’ inability to follow ethical standards and rules.
PubMed References for Artery of Percheron Infarct
At any given time this link will provide references from Pubmed, including the most recent updates. Retrievals are designed to include articles available free and also Indian studies.
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