%0 Journal Article %A James Bailey %A Kayvan Khadjooi %T Lesson of the month 1: Artery of Percheron occlusion – an ­uncommon cause of coma in a middle-aged man %D 2016 %R 10.7861/clinmedicine.16-1-86 %J Clinical Medicine %P 86-87 %V 16 %N 1 %X Bilateral paramedian thalamic infarction resulting from artery of Percheron occlusion presents with a distinct clinical syndrome comprising impaired consciousness, often with vertical gaze palsy and memory impairment. This uncommon anatomical variant arises as a single artery supplying both paramedian thalami. Early recognition can be challenging in the obtunded patient, where the differential diagnosis is broad. The acute physician should consider this diagnosis in a patient presenting with unexplained coma so that emergent treatments such as thrombolysis can be employed. Early imaging with computerised tomography can often be normal; therefore the use of magnetic resonance imaging is essential in confirming the diagnosis. %U https://www.rcpjournals.org/content/clinmedicine/16/1/86.full.pdf