title: Bilateral thalamic infarcts due to occlusion of the Artery of Percheron and discussion of the differential diagnosis of bilateral thalamic lesions.
abstract: The Artery of Percheron is a rare vascular variant in which a single dominant thalamoperforating artery arises from one P1 segment and bifurcates to supply both paramedian thalami. Occlusion of this uncommon vessel results in a characteristic pattern of bilateral paramedian thalamic infarcts with or without mesencephalic infarctions. We report a case of a 31-year-old man with acute bilateral thalamic infarcts and a truncated Artery of Percheron demonstrated on magnetic resonance angiography (MRA). Occlusion of the vessel was presumably due to embolism from a patent foramen ovale that was subsequently closed. The case presentation is followed by a discussion of bilateral paramedian thalamic infarcts including the causes and clinical presentation. The differential diagnosis of vascular and nonvascular etiologies of bilateral thalamic lesions is also discussed.
authors.affiliation: Department of Radiology, Lenox Hill Hospital, New York, USA.
authors.forename: Eva Guy
authors.initials: EG
authors.lastname: Rodriguez
authors.affiliation: Department of Radiology, Lenox Hill Hospital, New York, USA.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Lee
mesh_terms: D000328:Adult; D020520:Brain Infarction / Q000175:diagnosis / Q000209:etiology*; D002536:Cerebral Arteries / Q000033:anatomy & histology*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013788:Thalamus / Q000098:blood supply*
keywords: Artery of Percheron; bilateral thalamic infarcts; patent foramen ovale