scholarly journals Transient coma as Percheron’s artery stroke

2019 ◽  
Author(s):  
Maria sofia Cotelli ◽  
Patrizia Civelli ◽  
Elisa Tosana ◽  
Marinella Turla
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Anatomic Variation ◽  
Brain Structures ◽  
Characteristic Pattern ◽  
Caucasian Woman ◽  
Arterial Trunk ◽  
Artery Of Percheron ◽  
The Brain ◽  
Thalamic Infarcts

The artery of Percheron is a rare anatomic variation in the brain vascularization, in which a single arterial trunk arises from the posterior cerebral artery to supply both sides of brain structures, i.e., the thalamus and midbrain. Occlusion of this uncommon vessel results in a characteristic pattern of bilateral paramedian thalamic infarcts with or without mesencephalic infarctions. We report the case of a Caucasian woman who completely recovers after transient coma due to Percheron artery infarction.

scholarly journals Multispectral molecular imaging of capillary endothelium to facilitate preoperative endovascular brain mapping

2009 ◽  
Vol 110 (5) ◽  
pp. 975-980 ◽  
Author(s):  
H. Charles Manning ◽  
Sheila D. Shay ◽  
Robert A. Mericle
Keyword(s):  
Molecular Imaging ◽  
Cerebral Artery ◽  
Brain Mapping ◽  
Right Hemisphere ◽  
Posterior Cerebral Artery ◽  
Vascular Occlusion ◽  
Brain Parenchyma ◽  
Capillary Endothelium ◽  
Imaging Probe ◽  
The Brain

Object Brain mapping aims to localize neurological function to specific regions of the human brain. Preoperative endovascular brain mapping (PEBM) is a novel approach that allows clear visualization of nonfunctional (silent) brain parenchyma in real time during a resection. It has potential to improve neurosurgical guidance because brain shift does not alter the maps, and the map is visualized directly on the brain in situ rather than on a nearby image. Therefore, the risk of a new neurological deficit should be reduced. The authors report the first PEBM approach that combines selective molecular targeting of brain endothelium with multispectral (optical) imaging in preclinical animal models. Methods Sprague-Dawley rats and New Zealand white rabbits were selectively catheterized, and a fluorescein isothiocyanate–derivatized tomato lectin–based imaging probe was administered into the carotid artery or posterior cerebral artery, measuring < 500 μm in diameter. After binding/uptake of the imaging probe, and removal of unbound probe, a craniotomy was performed to directly visualize the “brain map.” Results Selective localization of the imaging probe to the right hemisphere in rats or right posterior cerebral artery in rabbits was clearly visualized after craniotomy. Cross-sections of stained capillaries demonstrated that the imaging probe did not cause vascular occlusion. Gross regional selectivity of the imaging probe was documented by multispectral molecular imaging of intact brains, with discrete localization and endothelium-directed targeting validated by histological examination. Conclusions The authors have demonstrated the first molecular endothelium-targeted approach to PEBM that does not require manipulation of the intact blood-brain barrier or result in vascular occlusion. Furthermore, the presented multispectral molecular imaging technique appears to be a suitable methodology for the generation of region-selective brain maps of vascularized brain parenchyma. Further refinement of the PEBM approach, as well as the development of improved imaging probes, may result in clinical advancement of PEBM where direct visual discrimination of nonfunctional silent brain parenchyma at the time of resection could significantly improve neurosurgical outcomes.

scholarly journals Percheron Artery Ischemia: Case Report

2021 ◽  
Author(s):  
Lília Tereza Diniz Nunes ◽  
Flávia S. Silva ◽  
Karyme G. Aota ◽  
Maria Beatriz Miranda. S. B. de Assis ◽  
João Fellipe B. Bento ◽  
...  
Keyword(s):  
Case Report ◽  
Cerebral Artery ◽  
Cervical Dystonia ◽  
Clinical Presentation ◽  
Posterior Cerebral Artery ◽  
Artery Of Percheron ◽  
Thalamic Infarction ◽  
Level Of Consciousness ◽  
Artery Segment ◽  
Thalamic Infarct

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.

Bilateral thalamic infarction due to artery of Percheron occlusion: a case report

2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Maleeha Shah ◽  
Muhammad Daniyal Nadeem ◽  
Ayesha Saleem ◽  
Muhammad Taimoor Khan ◽  
Neelam Asghar
Keyword(s):  
Cerebral Arteries ◽  
Limb Weakness ◽  
Arterial Trunk ◽  
Artery Of Percheron ◽  
Thalamic Infarction ◽  
Wide Range ◽  
Bilateral Lower Limb ◽  
Initial Imaging ◽  
The Brain ◽  
Posterior Cerebral Circulation

The artery of Percheron is a rare variant of the posterior cerebral circulation. It is characterised by a single arterial trunk that supplies blood to bilateral paramedian thalami and rostral midbrain. Its occlusion can have a very wide range of presentation, and initial imaging including CT of the head maybe normal. Diagnosis and eventual treatment is usually delayed. We describe the case of an elderly man who presented with loss of consciousness, aphasia, and bilateral lower limb weakness. He was diagnosed with bilateral thalamic infarction due to the occlusion of the artery of Percheron only after an MRI of the brain was performed. Despite treatment his symptoms did not resolve completely. Keywords: Thalamus/blood supply, Cerebral arteries, Magnetic Resonance Imaging.

Cerebrovascular Disease 1: Vascular Territories (DRAFT)

2018 ◽  
Author(s):  
Tamara Kaplan ◽  
Tracey Milligan
Keyword(s):  
Cerebrovascular Disease ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Sensory Loss ◽  
Homonymous Hemianopia ◽  
Leg Weakness ◽  
Sensory Changes ◽  
The Brain

The video in this chapter explores cerebrovascular disease, and focuses on vascular territories. It discusses the middle cerebral artery (MCA), posterior cerebral artery (PCA), and anterior cerebral artery (ACA), along with the portions of the brain they supply, as well as the different presentations of stroke in the three territories - contralateral weakness, sensory loss, and aphasia in MCA stroke, contralateral homonymous hemianopia in PCA stroke, and contralateral leg weakness and sensory changes in ACA stroke.

Bilateral Thalamic Infarcts Complicating Basilar Tip Aneurysm Coil Embolisation

1997 ◽  
Vol 3 (4) ◽  
pp. 325-328
Author(s):  
H.J. Cloft ◽  
D.F. Kallmes ◽  
G. Lanzino ◽  
M.E. Jensen ◽  
J.E. Dion
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Stenosis ◽  
Partial Occlusion ◽  
Guglielmi Detachable Coils ◽  
Coil Embolisation ◽  
Detachable Coils ◽  
Basilar Tip Aneurysm ◽  
Thalamic Infarcts

We report a case of bilateral thalamic infarcts with no apparent cause other than unilateral partial occlusion of the P1 segment of the posterior cerebral artery caused by Guglielmi detachable coils in a basilar tip aneurysm. This case demonstrates that bilateral thalamic infarctions can result from a unilateral posterior cerebral artery stenosis or occlusion, and does not necessarily imply bilateral posterior cerebral artery abnormality.

scholarly journals Uncommon Association of Two Anatomical Variants of Cerebral Circulation: A Fetal-Type Posterior Cerebral Artery and Inferred Artery of Percheron, Complicated with Paramedian Thalamomesencephalic Stroke—Case Presentation and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Aurelian Anghelescu
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Retrospective Case ◽  
Case Presentation ◽  
Lifestyle Risk Factors ◽  
Artery Of Percheron ◽  
Thalamic Infarction ◽  
Tobacco Abuse ◽  
Lifestyle Risk ◽  
Clinical Source

Background. The unilateral fetal variant of the posterior cerebral artery (FPCA) is characterized by the congenital absence of the P1 arterial segment. The artery of Percheron (AOP) is an uncommon vascular variant, in which a single dominant thalamoperforating arterial trunk arises from one P1 segment, bifurcates, and provides bilateral supply to the paramedian thalami and rostral midbrain. Case Presentation. This is a retrospective case study of a 37-year-old man with multiple lifestyle risk factors (chronic marijuana and tobacco abuse), who suffered a thalamomesencephalic stroke, rapidly worsening to comatose state. After restoration of consciousness, he clinically manifested with left paramedian midbrain syndrome. Imaging demonstrated an asymmetric paramedian thalamic infarction with mesencephalon extension, patency of the basilar, vertebral arteries, and left PCA and right-sided FPCA, respectively. Left-sided thalamoperforating arterioles were not differentiated; AOP was inferred. Neither evident clinical source of embolus nor prothrombotic states were found. Mobile cardiac telemetry and transesophageal echocardiography were not available. The diagnosis was established too late for thrombolytic treatment. Anticoagulation was indicated during the acute and subacute stages, followed by low dose of antiplatelet. Discussion. This uncommon cerebrovascular configuration (FPCA+AOP) might be the fourth case described in the literature. Sustained rehabilitation and abstinence from tobacco and cannabis led to favorable outcomes.

scholarly journals Behavioural test battery for the Back of the Brain project

2021 ◽  
Author(s):  
Ro Julia Robotham ◽  
Sheila Kerry ◽  
Grace E Rice ◽  
Alex Leff ◽  
Matt Lambon Ralph ◽  
...  
Keyword(s):  
Visual Perception ◽  
Cerebral Artery ◽  
Visual Recognition ◽  
Posterior Cerebral Artery ◽  
Test Battery ◽  
Low Level ◽  
Symptom Profile ◽  
Behavioural Test ◽  
High Level ◽  
The Brain

Much of the patient literature on the visual recognition of faces, words and objects is based on single case studies of patients selected according to their symptom profile. The Back of the Brain project aims to provide novel insights into the cerebral and cortical architecture underlying visual recognition of complex stimuli by adopting a different approach. A large group of patients was recruited according to their lesion location (in the areas supplied by the posterior cerebral artery) rather than their symptomatology. All patients were assessed with the same battery of sensitive tests of visual perception enabling the identification of dissociations as well as associations between deficits in face, word and object recognition. This paper provides a detailed description of the extensive behavioural test battery that was developed for the Back of the Brain project and that enables assessment of low-level, intermediate and high-level visual perceptual abilities. •Extensive behavioural test battery for assessing low-level, intermediate and high-level visual perception in patients with posterior cerebral artery stroke •Method enabling direct comparison of visual face, word and object processing abilities in patients with posterior cerebral artery stroke

Artery of Percheron Infarction: A Characteristic Pattern of Ischemia and Variable Clinical Presentation: a literature review

2020 ◽  
Vol 16 ◽  
Author(s):  
Osama Kheiralla ◽  
Salem Alghamdi ◽  
Rowa Aljondi ◽  
Abdulrahman Tajaldeen ◽  
Adel Othman Bakheet
Keyword(s):  
Clinical Presentation ◽  
Correct Diagnosis ◽  
Small Diameter ◽  
Characteristic Pattern ◽  
Arterial Trunk ◽  
Appropriate Treatment ◽  
Clinical Presentations ◽  
Artery Of Percheron ◽  
Diagnostic Difficulties ◽  
Thalamic Infarct

: The Artery of Percheron (AOP) is an uncommon anatomic variant that provides arterial supply to the paramedian region of the thalami and bilaterally to the rostral part of the midbrain; it is a solitary arterial trunk that branches from a proximal segment of the posterior cerebral artery (PCA). Although AOP infarction results in a characteristic pattern of ischemia—namely bilateral paramedian thalamic infarct with or without midbrain involvement— it may cause diagnostic difficulties due to the variety of its clinical presentations and wide differentials, as well as its small diameter and the difficulty of obtaining visualization through diagnostic imaging. Early neuroimaging of AOP infarction and correct diagnosis are mandatory for early initiation of the appropriate treatment and better patient outcomes. In this study, we discuss imaging the patterns of AOP infarction, as well as its differentials and clinical presentation.

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