title: Clinical spectrum of artery of Percheron infarct: clinical-radiological correlations.
abstract: BACKGROUND
  The occlusion of the artery of Percheron results in bilateral thalamic and mesencephalic infarctions. In this series, we attempted to classify the subtypes of clinical presentations and long-term prognosis with regards to radiological patterns.
  
  
  METHODS
  We sought the clinical and radiological findings of 15 (8 men and 7 women; mean age 48 years) consecutive patients with Percheron artery infarct over 10 years. We classified the clinical symptoms according to the presence of a mental status disturbance (MSD), behavioral amnesic impairment (BAI), aphasia/dysarthria, ocular movement disorders (OMDs), motor deficit, cerebellar signs, and others. The Percheron artery infarct images were classified as bilateral paramedian thalamic with rostral midbrain infarction (BPTRMI), bilateral paramedian thalamic without midbrain infarction (BPTWMI), bilateral paramedian and anterior thalamic with midbrain infarction (BPATMI), and bilateral paramedian and anterior thalamic without midbrain infarction. The outcome was evaluated using a modified Rankin Scale (mRS).
  
  
  RESULTS
  OMD and MSD were the most common clinical manifestations in patients with BPTRMI (n = 8). BAI and MSD were the main clinical findings in patients with BPTWMI (n = 6). A patient with BPATMI had a combination of clinical manifestations. After a mean follow-up of 55 months, a good outcome (mRS score ≤ 2) was present in 25% of the patients with BPTRMI, 67% of the patients with BPTWMI, and in 1 patient with BPATMI.
  
  
  CONCLUSIONS
  Our findings suggest that it is possible to identify clinical and radiological subgroups of Percheron artery infarct. The long-term follow-up outcome is generally good, except in cases with midbrain involvement.
authors.affiliation: Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico. Electronic address: antonio.arauz@prodigy.net.mx.
authors.forename: Antonio
authors.initials: A
authors.lastname: Arauz
authors.affiliation: Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
authors.forename: Hernán M
authors.initials: HM
authors.lastname: Patiño-Rodríguez
authors.affiliation: Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Vargas-González
authors.affiliation: Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
authors.forename: Nayelli
authors.initials: N
authors.lastname: Arguelles-Morales
authors.affiliation: Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
authors.forename: Humberto
authors.initials: H
authors.lastname: Silos
authors.affiliation: Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
authors.forename: Angélica
authors.initials: A
authors.lastname: Ruiz-Franco
authors.affiliation: Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Ochoa
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography / Q000379:methods; D002544:Cerebral Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D038524:Diffusion Magnetic Resonance Imaging; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008636:Mesencephalon / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008875:Middle Aged; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013788:Thalamus / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed
keywords: Bithalamic infarct; anterior thalamic infarct; artery of Percheron; ischemic stroke; paramedian thalamic infarct