RT Journal Article
SR Electronic
T1 Lesson of the month 1: Artery of Percheron occlusion – an ­uncommon cause of coma in a middle-aged man
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 86
OP 87
DO 10.7861/clinmedicine.16-1-86
VO 16
IS 1
A1 James Bailey
A1 Kayvan Khadjooi
YR 2016
UL http://www.rcpjournals.org/content/16/1/86.abstract
AB 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.