Original ArticleClinical Spectrum of Artery of Percheron Infarct: Clinical–Radiological Correlations
Section snippets
Background
The blood supply to the human thalami is complex and has multiple variants. The artery of Percheron is one of those variants and is characterized by a solitary arterial trunk that branches from one of the proximal segments of either of the posterior cerebral arteries (Fig 1) and supplies blood to the paramedian thalami.1 This type of variation is present in 4%-12% of the population.2, 3, 4, 5, 6, 7 Occlusion of this artery is rare and results in a bilateral paramedian thalamic infarction that
Patients and Methods
We studied 15 consecutive patients with Percheron artery infarct, as diagnosed by both CT and MRI, who were admitted to our stroke clinic over 10 years. Patients were included in the current series if there was evidence of a first-ever bilateral simultaneous paramedian thalamic infarct using standard axial, sagittal, and coronal MRI sequences. We excluded patients with an isolated thalamic infarct, infarct of the cerebral posterior artery, basilar thrombosis, and cerebral deep venous
Results
There were 15 patients (8 men and 7 women; mean age ± SD = 48 ± 14 years) with Percheron artery infarct (.4% of 3750 patients with a first-ever ischemic stroke). Table 1 shows the risk factors and clinical findings for all the cases. Hypertension was present in 5 patients (33%), current smoking in 4 (26%), patent foramen ovale in 3 (20%), and diabetes mellitus in 2 (13%). None of the patients had previous transient ischemic attacks.
The presumed cause of Percheron artery infarct was small-vessel
Discussion
Our series is an MRI-based study on the clinical findings of a Percheron artery infarct. In our stroke registry, they were found in .4% of patients with a first-ever stroke. The prevalence of Percheron artery is unknown. A small study of 15 cadaver brains demonstrated the Percheron artery in 1 specimen.4 To date, the diagnosis of Percheron artery infarct has been uncommon. In 2 large stroke series, the characteristic Percheron artery infarct pattern was estimated to occur in .1% and .3% of all
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Topographic evaluation of bithalamic infarcts: Are these due to occlusion of the artery of Percheron?
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Conflict of interest: None.
Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Ethics approval: National Institute of Neurology and Neurosurgery ethics committee.