Hemichorea due to ipsilateral thalamic infarction: A case report

Context: The Artery of Percheron (AOP) is an uncommon anatomic vascular variation derivated from posterior cerebral artery segment P1, wich branchs to irrigate bilaterally the thalamus in it is paramedian portion. Amidst vascular cerebral events of the ischemic type, thalamic infarction occour in 11% of the cases. The typical clinical presentation is constituted by the triad: cogniyivebehavior comitente, oculomotors and consience disturbs. Case report: J.F.M.L, 51 years old, male, was found unconscious in his residence by SAMU and then interned in Stroke Room of HGP in 02/06/2020 with a lowered level of consciousness (Glasgow 8). The tests demonstrated a bilateral thalamic infarct due to Artery of Percheron Ischemia. In 02/09/2020 it evolved into a Glasgow 9 being extubated. The CT after 3 days demonstrated absence of bleeding and prophylatically initiated simvastatin, clexane, physiotherapy and phonoaudiology. In 02/15/2020, during physical exam, the pacient was lucid, presented behavior alterations, had left cervical dystonia and ataxia. The patient progressed well and was discharged the next day. Conclusions: The AOP, when occluded, results in bilateral paramedian thalamic and the rostral midbrain infarctions wich may cause diagnosis issues, mainly because of the vast specter of diferential diagnosis. In the presence of triad signals characteritic of bilateral thalamic infarction in CT, it must suspect the manifestation of such entity.

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Abnormal Ocular Movement With Executive Dysfunction and Personality Change in Subject With Thalamic Infarction: A Case Report

Annals of Rehabilitation Medicine ◽

10.5535/arm.2015.39.6.1033 ◽

2015 ◽

Vol 39 (6) ◽

pp. 1033 ◽

Cited By ~ 1

Author(s):

Ee Jin Kim ◽

Myeong Ok Kim ◽

Chang Hwan Kim ◽

Kyung Lim Joa ◽

Han Young Jung

Keyword(s):

Case Report ◽

Executive Dysfunction ◽

Personality Change ◽

Thalamic Infarction ◽

Ocular Movement

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Paramedian thalamic infarction with transient pseudoabducens palsy: a case report

Nosotchu ◽

10.3995/jstroke.35.232 ◽

2013 ◽

Vol 35 (3) ◽

pp. 232-234

Author(s):

Makoto Nomura ◽

Hirotsugu Mikami ◽

Takeshi Watanabe ◽

Megumi Suzuki ◽

Seiitsu Ono

Keyword(s):

Case Report ◽

Thalamic Infarction

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A case report: Numb Chin Syndrome due to thalamic infarction: a rare case

BMC Neurology ◽

10.1186/s12883-019-1525-x ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Florian Rimmele ◽

Henning Maschke ◽

Annette Großmann ◽

Tim P. Jürgens

Keyword(s):

Case Report ◽

Rare Case ◽

Sensory Neuropathy ◽

Acute Ischemia ◽

Lower Lip ◽

Numb Chin Syndrome ◽

Thalamic Infarction ◽

Cranial Mri ◽

The Right ◽

Underlying Diseases

Abstract Background Numb Chin Syndrome (NCS), which is also characterized as sensory neuropathy of the mental nerve, describes a mostly unilateral numbness of the chin and lower lip. Benign and malignant diseases are known to cause this circumscribed symptom, which can easily be overlooked or misdiagnosed. In this article we present the very rare case of a clinical NCS caused by thalamic lacunar infarction. As a pure sensory stroke it is a rare variant of the Cheiro-Oral Syndrome (COS). Case presentation A 63-year-old male patient received an emergency referral to our department after the patient had noticed a feeling of numbness of the left lower lip and chin on the previous day. The neurological examination revealed an approximately 2 × 3 cm area of hypoesthesia in the area of the chin and left lower lip and the cranial MRI an acute ischemia in the right thalamus. Conclusions In this case report we introduce a patient who clinically shows an NCS. Various diseases may be responsible for NCS, including malignancies or even central neurological disorders such as multiple sclerosis. A lacunar thalamic ischemia as a cause of NCS is very rare and to our knowledge described in the literature only in the contex of a COS in three cases. We wish to remind the reader, through this case, of the purely descriptive and syndromal character of the NCS and the importance for detecting underlying diseases. Furthermore we give a brief overview of the NCS and causative disorders.

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Neurobrucellosis with thalamic infarction: a case report

Neurological Sciences ◽

10.1007/s10072-008-1017-z ◽

2008 ◽

Vol 29 (6) ◽

pp. 481-483 ◽

Cited By ~ 8

Author(s):

Thomas Jochum ◽

Uta Kliesch ◽

Reinhard Both ◽

Jochen Leonhardi ◽

Karl-Jürgen Bär

Keyword(s):

Case Report ◽

Thalamic Infarction

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Unilateral thalamic infarction presenting as vertical gaze palsy: a case report

Journal of Medical Case Reports ◽

10.1186/1752-1947-5-535 ◽

2011 ◽

Vol 5 (1) ◽

Cited By ~ 2

Author(s):

Muhib Khan ◽

Christos Sidiropoulos ◽

Panayiotis Mitsias

Keyword(s):

Case Report ◽

Thalamic Infarction ◽

Vertical Gaze ◽

Gaze Palsy

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Lowering of the level of consciousness by bilateral paramedian thalamic infarction due to Percheron’s ischemia (Percheron’s syndrome): a case report

10.5327/1516-3180.370 ◽

2021 ◽

Author(s):

Mariana Sandy Mada

Keyword(s):

Case Report ◽

Latin American ◽

Clinical Presentation ◽

Altered Mental Status ◽

Caribbean Literature ◽

Laboratory Evaluation ◽

Anatomical Variant ◽

Loss Of Self ◽

Thalamic Infarction ◽

Level Of Consciousness

Context: Ischemia of Percheron’s artery(PA) is a rare neurological occurrence that results in bilateral paramedian thalamic infarction that may affect the midbrain. Among the symptoms are altered mental status, vertical ocular palsy, and memory changes, as well as hemiplegia, cerebellar ataxia, and movement disorders. Objective: To elucidate a case of stroke of the mesencephalic trunk in an uncommon anatomical variant of the thalamus-perfurans arteries Method:Daily neurological and laboratory evaluation in addition to complementary examinations such as skull CT and skull MRI. We also performed a qualitative analysis of articles in Portuguese and English journals indexed in the following databases: PubMed (Public Medical Literature Analysis), Lilacs (Latin American and Caribbean Literature on Health Sciences) and Scielo (Scientific Eletronic Library Online). Case report: A 67 year old male presented with mild to moderate headache for 2 days, reporting chronic cough and decreased level of consciousness for 1 day. He was intubated (Glasgow 6) and sedated for diagnostic elucidation. The CT shows mild cerebral edema and MRI shows bilateral thalamic infarction affecting the PA. The clinical picture evolves to ischemic stroke of the mesencephalic trunk. Discussion: The bilateral infarction of the Percheron artery, as presented in this case, the neurological and neuropsychological manifestations are more severe such as akinetic mutism, thalamic dementia and loss of self psychic activation(Robot Syndrome). In these cases, the neuropsychological disturbance is best noticed when the patient regains consciousness. Conclusion: In the presence of a clinical presentation suggestive of bilateral thalamic infarction, the Percheron Syndrome hypothesis should be suspected.

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Bilateral post traumatic thalamic infarct: rare case report

Romanian Neurosurgery ◽

10.2478/romneu-2014-0065 ◽

2014 ◽

Vol 21 (4) ◽

pp. 481-484

Author(s):

Sumeet Singh ◽

R.S. Mittal ◽

Achal Sharma

Keyword(s):

Case Report ◽

Rare Variant ◽

World Literature ◽

Rare Case ◽

Arterial Supply ◽

Artery Of Percheron ◽

Thalamic Infarction ◽

Rare Case Report ◽

Post Traumatic ◽

Thalamic Infarct

Abstract Bilateral thalamic infarction is rarely seen in cases with artery of Percheron embolization. Artery of Percheron is a rare variant of arterial supply to both thalamus and midbrain. Occlusion of this artery following trauma and causing bilateral thalamic infarction is rare and very few cases are reported in world literature.

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