Artery of percheron infarct: a case report

Artery of Percheron is a part of the posterior circulation occlusion of which is relatively uncommon. It is classically characterised by bilateral infarcts in areas involving the rostral midbrain and/or ventromedial thalamus best seen by a diffusion-weighted imaging (DWI) sequence using MRI. Clinical presentations are variable and include, amnesic impairment, aphasia, dysarthria, ocular movement disorders, motor deficit and cerebellar signs. Our case was a 60-year-old hypertensive and diabetic male with history of alcohol abuse who presented with sudden derangement of sensorium along with restriction of ocular movements and marked cerebellar signs. The diagnosis of werniche encephalopathy suggested initially by the radiologist was rejected because of the acute onset, history of hypertension and marked cerebellar signs which suggested a cerebrovascular accident. Bilateral infarcts with the occlusion of a single artery i.e. artery of percheron which supplies structures bilaterally can easily be confused with werniche encephalopathy which has similar clinical and radiological picture but are managed on different lines. This diagnosis should be kept in mind in drowsy patients with restricted ocular movements and bilateral thalamic and midbrain hyperintensities

Artery of percheron infarct: a case report

Artery of Percheron is a part of the posterior circulation occlusion of which is relatively uncommon. It is classically characterised by bilateral infarcts in areas involving the rostral midbrain and/or ventromedial thalamus best seen by a diffusion-weighted imaging (DWI) sequence using MRI. Clinical presentations are variable and include, amnesic impairment, aphasia, dysarthria, ocular movement disorders, motor deficit and cerebellar signs. Our case was a 60-year-old hypertensive and diabetic male with history of alcohol abuse who presented with sudden derangement of sensorium along with restriction of ocular movements and marked cerebellar signs. The diagnosis of werniche encephalopathy suggested initially by the radiologist was rejected because of the acute onset, history of hypertension and marked cerebellar signs which suggested a cerebrovascular accident. Bilateral infarcts with the occlusion of a single artery i.e. artery of percheron which supplies structures bilaterally can easily be confused with werniche encephalopathy which has similar clinical and radiological picture but are managed on different lines. This diagnosis should be kept in mind in drowsy patients with restricted ocular movements and bilateral thalamic and midbrain hyperintensities

Multicenter Case–Control Study of COVID-19–Associated Mucormycosis Outbreak, India

We performed a case–control study across 25 hospitals in India for the period of January–June 2021 to evaluate the reasons for an COVID-19–associated mucormycosis (CAM) outbreak. We investigated whether COVID-19 treatment practices (glucocorticoids, zinc, tocilizumab, and others) were associated with CAM. We included 1,733 cases of CAM and 3,911 age-matched COVID-19 controls. We found cumulative glucocorticoid dose (odds ratio [OR] 1.006, 95% CI 1.004–1.007) and zinc supplementation (OR 2.76, 95% CI 2.24–3.40), along with elevated C-reactive protein (OR 1.004, 95% CI 1.002–1.006), host factors (renal transplantation [OR 7.58, 95% CI 3.31–17.40], diabetes mellitus [OR 6.72, 95% CI 5.45–8.28], diabetic ketoacidosis during COVID-19 [OR 4.41, 95% CI 2.03–9.60]), and rural residence (OR 2.88, 95% CI 2.12–3.79), significantly associated with CAM. Mortality rate at 12 weeks was 32.2% (473/1,471). We emphasize the judicious use of COVID-19 therapies and optimal glycemic control to prevent CAM