Highlights
- •Bilateral paramedian thalamic infarcts lead to decreased level of consciousness.
- •Rostral midbrain infarcts lead to oculomotor nerve palsies.
- •Bilateral thalamic – midbrain infarction syndrome is suggestive of AOP infarction.
Abstract
Bilateral thalamic strokes due to Artery of Percheron (AOP) occlusion are rare but
have been previously reported in the literature. It is due to a rare anatomic variant
where a solitary arterial trunk from the proximal segment of either posterior cerebral
artery (PCA) supplies bilateral thalami and midbrain. Despite its description in the
literature, these strokes are usually missed and patient’s symptoms are not thought
to be secondary to a vascular etiology. Through this report we aim to describe the
clinical and radiographic features seen in these patients. We describe a series of
6 patients who present with varying levels of somnolence and oculomotor nerve palsies
who had an occlusion of the AOP with bilateral thalamic infarcts with midbrain involvement.
These clinical presentations, combined with the “V” sign on MRI are important in making
the diagnosis.
Keywords
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References
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Article info
Publication history
Published online: November 21, 2018
Accepted:
November 11,
2018
Received:
September 25,
2018
Footnotes
☆Presented as a poster at AAN 2016 in Boston, MA and the abstract was published in Neurology. 2016;86(16 Supplement).
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
