Artery of Percheron Stroke: A Case Report

Background: The Artery of Percheron (AOP) is a vascular variant supplying both sides of the thalamus, present in up to one-quarter of the general population. AOP occlusion is a rare cause of ischemic stroke, resulting in bilateral thalamic infarction. It typically manifests as altered consciousness...

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Main Authors: Milda Navickaitė, Aleksandras Vilionskis, Austėja Dapkutė, Kristina Ryliškienė
Format: Article
Language:English
Published: Vilnius University Press 2025-03-01
Series:Acta Medica Lituanica
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Online Access:https://www.zurnalai.vu.lt/AML/article/view/38613
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author Milda Navickaitė
Aleksandras Vilionskis
Austėja Dapkutė
Kristina Ryliškienė
author_facet Milda Navickaitė
Aleksandras Vilionskis
Austėja Dapkutė
Kristina Ryliškienė
author_sort Milda Navickaitė
collection DOAJ
description Background: The Artery of Percheron (AOP) is a vascular variant supplying both sides of the thalamus, present in up to one-quarter of the general population. AOP occlusion is a rare cause of ischemic stroke, resulting in bilateral thalamic infarction. It typically manifests as altered consciousness, gaze abnormalities, and cognitive impairment. Neuroimaging of AOP stroke is challenging, as head CT is often unremarkable. However, a diagnostic ‘V’ sign can be identified on MRI. AOP stroke is treated as other types of ischemic stroke.Case description: We present a case of a 61-year-old male with a history of alcohol abuse, diagnosed with ischemic AOP stroke. He presented with sudden loss of consciousness, third nerve palsy, and vertical gaze palsy. MRI revealed bilateral paramedian thalamic infarction with midbrain involvement. Despite conservative treatment, his condition showed minimal improvement, leaving him lethargic and dysarthric. He was discharged to palliative care after two weeks.Conclusions: AOP infarction, though rare, should be considered in patients with altered consciousness. Early MRI is essential for accurate diagnosis and timely treatment, highlighting the importance of physician awareness of this condition.
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2029-4174
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publishDate 2025-03-01
publisher Vilnius University Press
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series Acta Medica Lituanica
spelling doaj-art-c7a35bcb71ff4802b7ddcf8557802cea2025-08-20T01:52:19ZengVilnius University PressActa Medica Lituanica1392-01382029-41742025-03-0132110.15388/Amed.2025.32.1.14Artery of Percheron Stroke: A Case ReportMilda Navickaitė0https://orcid.org/0009-0000-3738-1319Aleksandras Vilionskis1https://orcid.org/0000-0002-8055-3558Austėja Dapkutė2Kristina Ryliškienė3https://orcid.org/0000-0001-9596-1733Faculty of Medicine, Vilnius UniversityClinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius UniversityFaculty of Medicine, Vilnius UniversityClinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University Background: The Artery of Percheron (AOP) is a vascular variant supplying both sides of the thalamus, present in up to one-quarter of the general population. AOP occlusion is a rare cause of ischemic stroke, resulting in bilateral thalamic infarction. It typically manifests as altered consciousness, gaze abnormalities, and cognitive impairment. Neuroimaging of AOP stroke is challenging, as head CT is often unremarkable. However, a diagnostic ‘V’ sign can be identified on MRI. AOP stroke is treated as other types of ischemic stroke.Case description: We present a case of a 61-year-old male with a history of alcohol abuse, diagnosed with ischemic AOP stroke. He presented with sudden loss of consciousness, third nerve palsy, and vertical gaze palsy. MRI revealed bilateral paramedian thalamic infarction with midbrain involvement. Despite conservative treatment, his condition showed minimal improvement, leaving him lethargic and dysarthric. He was discharged to palliative care after two weeks.Conclusions: AOP infarction, though rare, should be considered in patients with altered consciousness. Early MRI is essential for accurate diagnosis and timely treatment, highlighting the importance of physician awareness of this condition. https://www.zurnalai.vu.lt/AML/article/view/38613artery of Percheronischemic strokethalamic infarctmidbrain
spellingShingle Milda Navickaitė
Aleksandras Vilionskis
Austėja Dapkutė
Kristina Ryliškienė
Artery of Percheron Stroke: A Case Report
Acta Medica Lituanica
artery of Percheron
ischemic stroke
thalamic infarct
midbrain
title Artery of Percheron Stroke: A Case Report
title_full Artery of Percheron Stroke: A Case Report
title_fullStr Artery of Percheron Stroke: A Case Report
title_full_unstemmed Artery of Percheron Stroke: A Case Report
title_short Artery of Percheron Stroke: A Case Report
title_sort artery of percheron stroke a case report
topic artery of Percheron
ischemic stroke
thalamic infarct
midbrain
url https://www.zurnalai.vu.lt/AML/article/view/38613
work_keys_str_mv AT mildanavickaite arteryofpercheronstrokeacasereport
AT aleksandrasvilionskis arteryofpercheronstrokeacasereport
AT austejadapkute arteryofpercheronstrokeacasereport
AT kristinaryliskiene arteryofpercheronstrokeacasereport