Percheron artery infarction in the differential diagnosis of acute confusional state with normal initial brain MRI

Excerpt

The artery of Percheron (AOP) is a solitary trunk representing an uncommon anatomic variant that provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions [1]. AOP prevalence remains unknown, bilateral thalamic infarcts are uncommon. In a recent study, AOP infarction was found in 0.4 % patients with a first-ever stroke in their stroke registry [2]. The clinical spectrum is very variable which makes the clinician consider about inflammatory, infectious, toxic cause of cerebral dysfunction in the differential diagnosis. We report a case without evident cause for acute disturbance of consciousness and normal early imaging of head computed tomography (CT) and brain magnetic resonance imaging (MRI). …