Abstract

GALNARES-OLALDE, JA et al. Bilateral thalamic infarct secondary to Percheron’s artery occlusion. Med. interna Méx. [online]. 2018, vol.34, n.1, pp.157-161. ISSN 0186-4866.  https://doi.org/10.24245/mim.v34i1.1531.

The Percheron’s artery is a vascular variant characterized by the presence of a dominant thalamic-perforating artery originated in the P1 segment of the posterior cerebral artery; it forks to irrigate both thalamus in its paramedial portion. Its obstruction results in bilateral thalamic infarcts in the paramedial site. This paper reports the case of an 85-year-old man evaluated for alterations in the state of consciousness, associated with little interaction with the environment and vertical paralysis of the gaze. MRI evidenced bilateral thalamic stroke. The presentation of bilateral thalamic lesions is rare. The thalamic infarcts represent 11% of the vascular events, and the bilateral events 22 to 35% of the thalamic vascular events; they usually have an embolic origin and they are rarely associated with hypoperfusion. The typical triad includes alterations of the state of consciousness, alterations of the memory and vertical paralysis of the gaze. Although this is an infrequent disease, it is important to consider the performance of imaging studies in patients with alterations of the state of consciousness that allow to discard thalamic infarctions as part of the differential diagnosis.

Keywords : Posterior cerebral artery; Thalamic infarcts; Stroke.

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