Clinical features of stroke in the artery of Percheron territory (case series)

Cover Page

Cite item

Full Text

Abstract

The article describes two clinical cases of stroke in the artery of Percheron territory. The difficulty in recognizing the causes of ischaemic stroke in these patients was due to the polymorphism in the mental disorders and the rare "strategic infarct dementia", as well as impaired consciousness. We hereby present the clinical features of this condition, which can be used together with neuroimaging methods (including various MRI sequences) to ensure a timely and accurate diagnosis.

The authors describe a clinical case to demonstrate their approach to the diagnosis and management of this patient group.

About the authors

Vladislav A. Annushkin

Research Center of Neurology

Author for correspondence.
Email: annushkin-v@mail.ru
ORCID iD: 0000-0002-9120-2550

aduate student, 1st Neurological department, Institute of Clinical and Preventive Neurology

Russian Federation, Moscow

Alexey A. Nikonov

Research Center of Neurology

Email: nikonoffff@mail.ru
ORCID iD: 0000-0003-4934-1423

Cand. Sci. (Med.), neurologist, 2nd Neurological department, Institute of Clinical and Preventive Neurology

Russian Federation, Moscow

Marina Yu. Maksimova

Research Center of Neurology

Email: ncnmaximova@mail.ru
ORCID iD: 0000-0002-7682-6672

D. Sci. (Med.), Professor, Head, 2nd Neurology department, Institute of Clinical and Preventive Neurology

Russian Federation, Moscow

Оlga V. Lagoda

Research Center of Neurology

Email: angionev@gmail.com
ORCID iD: 0000-0001-7562-4991

Cand. Sci. (Med.), senior researcher, 1st Neurological department, Institute of Clinical and Preventive Neurology

Russian Federation, Moscow

Marine M. Tanashyan

Research Center of Neurology

Email: M_Tanashyan2004@mail.ru
ORCID iD: 0000-0002-5883-8119

D. Sci. (Med.), Professor, Corresponding member of RAS, Deputy Director for science, Head, 1st Neurological department, Institute of Clinical and Preventive Neurology

Russian Federation, Moscow

References

  1. Percheron G. The anatomy of the arterial supply of the human thalamus and its use for the interpretation of the thalamic vascular pathology. Z. Neurol. 1973; 205(1): 1–13. doi: 10.1007/BF00315956
  2. Saida I.B., Saad H.B., Zghidi M. et al. Artery of Percheron stroke as an unusual cause of hypersomnia: a case series and a short literature review. Am. J. Mens. Health. 2020; 14(4): 1557988320938946. doi: 10.1177/1557988320938946
  3. Shams A., Hussaini S.A., Ata F. et al. bilateral thalamic infarction secondary to thrombosis of artery of Percheron. Cureus. 2021; 13(3): e13707. doi: 10.7759/cureus.13707
  4. Garcia-Grimshaw M.A., Peschard-Franco M., Gutierrez-Manjarrez F.A. Bilateral thalamic ischemic stroke secondary to occlusion of the artery of Percheron. Cureus. 2018; 10(5): e2676. doi: 10.7759/cureus.2676
  5. Carrera E., Michel P., Bogousslavsky J. Anteromedian, central, and posterola- teral infarcts of the thalamus: three variant types. Stroke. 2004; 35(12): 2826–2831. doi: 10.1161/01.STR.0000147039.49252.2f
  6. Arauz A., Patiño-Rodríguez H.M., Vargas-González J.C. et al. Clinical spectrum of artery of Percheron infarct: clinical-radiological correlations. J. Stroke Cerebrovasc. Dis. 2014; 23(5): 1083–1088. doi: 10.1016/j.jstrokecerebrovasdis.2013.09.01
  7. Tu S., Miller L., Piguet O., Hornberger M. Accelerated forgetting of contextual details due to focal medio-dorsal thalamic lesion. Front. Behav. Neurosci. 2014; 8: 320. doi: 10.3389/fnbeh.2014.00320
  8. Amin O.S., Shwani S.S., Zangana H.M. et al. Bilateral infarction of paramedian thalami: a report of two cases of artery of Percheron occlusion and review of the literature. BMJ Case Rep. 2011; 2011: bcr0920103304. doi: 10.1136/bcr.09.2010.3304
  9. Smith A.B., Smirniotopoulos J.G., Rushing E.J., Goldstein S.J. Bilateral thalamic lesions. Am. J. Roentgenol. 2009; 192(2): W53–W62.

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. A diagram of the thalamic vascular supply variants, as described by G. Percheron.

Download (95KB)
3. Fig. 2. A diagram of the involved vascular supply and brain matter during damage to the artery of Percheron.

Download (105KB)
4. Fig. 3. T2-weighted brain MRI (А) and DW-MRI (В). The arrows and circles indicate the post-stroke changes in the paramedian thalamus.

Download (78KB)
5. Fig. 4. T2-weighted brain MRI. The arrows indicate the post-stroke changes in the paramedian thalamus (A) and dilation of V4 in the right vertebral artery (B), with signs of mural thrombosis.

Download (93KB)
6. Fig. 5. Brain CT angiography with 3D reconstruction. The arrow indicates the right vertebral artery aneurysm in the intracranial part of V4.

Download (75KB)

Copyright (c) 2022 Annushkin V.A., Nikonov A.A., Maksimova M.Y., Lagoda О.V., Tanashyan M.M.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies