Bilateral thalamic infarcts due to occlusion of the Artery of Percheron and discussion of the differential diagnosis of bilateral thalamic lesions

Authors

  • Eva Guy Rodriguez
  • Jane A Lee

DOI:

https://doi.org/10.3941/jrcr.v7i7.961

Keywords:

Artery of Percheron, bilateral thalamic infarcts, patent foramen ovale

Abstract

The Artery of Percheron is a rare vascular variant in which a single dominant thalamoperforating artery arises from one P1 segment and bifurcates to supply both paramedian thalami. Occlusion of this uncommon vessel results in a characteristic pattern of bilateral paramedian thalamic infarcts with or without mesencephalic infarctions [1]. We report a case of a 31-year-old man with acute bilateral thalamic infarcts and a truncated Artery of Percheron demonstrated on magnetic resonance angiography (MRA). Occlusion of the vessel was presumably due to embolism from a patent foramen ovale that was subsequently closed. The case presentation is followed by a discussion of bilateral paramedian thalamic infarcts including the causes and clinical presentation. The differential diagnosis of vascular and nonvascular etiologies of bilateral thalamic lesions is also discussed.

Author Biographies

Eva Guy Rodriguez

PGY4 Radiology Resident

Jane A Lee

Neuroradiologist

Published

2013-07-19

Issue

Section

Neuroradiology