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