Viticchi Giovanna, Falsetti Lorenzo, Fiori Chiara, Jorio Giorgia, Plutino Andrea, Buratti Laura, Bartolini Marco, Silvestrini Mauro
Neurological Clinic, Marche Polytechnic University, Ancona, Italy.
Internal and Subintensive Medicine, Ospedali Riuniti, Ancona, Italy.
J Stroke Cerebrovasc Dis. 2016 Mar;25(3):572-7. doi: 10.1016/j.jstrokecerebrovasdis.2015.11.011. Epub 2015 Dec 11.
The Percheron artery (PA) is a rare variant vessel. Its acute occlusion can cause a bilateral symmetrical thalamic stroke, clinically manifested as a sudden alteration of consciousness that could vary from sleepiness to coma. In this paper, we illustrate a case of acute PA occlusion in a young, pregnant woman and present a review of the literature, focusing on the possible causes of the acute occlusion.
A 35-year-old woman, at the fourth week of pregnancy, came to the emergency department of our hospital because of a sudden onset and persistent loss of consciousness. Brain magnetic resonance imaging (MRI) showed a symmetrical and bilateral thalamic infarction without evidence of other ischemic lesions, compatible with an acute PA occlusion.
The patient, who showed full clinical recovery within a few hours of symptom onset, received a short-term anticoagulant treatment followed by aspirin for long-term prevention.
We reviewed the literature about the possible causes of acute PA occlusion. This ischemic condition is usually associated with cardioembolic or small-vessel disease. However, in our patient, we did not find any element supportive for coagulative alteration or embolyzing conditions.
The presence of this type of thalamic stroke should be considered in the management of persistent loss of consciousness. PA occlusion is rare, but it needs a brain MRI examination for a correct diagnosis, a narrow evaluation of all the possible causes, and a long-term anticoagulant therapy. Pregnancy itself should constitute a rare but possible cause of a PA occlusion.
大脑后动脉丘脑穿通动脉（PA）是一种罕见的变异血管。其急性闭塞可导致双侧对称性丘脑梗死，临床表现为意识突然改变，从嗜睡到昏迷不等。在本文中，我们阐述了一例年轻孕妇急性PA闭塞的病例，并对文献进行综述，重点关注急性闭塞的可能原因。
一名35岁女性，孕4周，因突发且持续意识丧失前来我院急诊科就诊。脑部磁共振成像（MRI）显示双侧对称性丘脑梗死，无其他缺血性病变证据，符合急性PA闭塞表现。
患者在症状出现后数小时内临床完全恢复，接受了短期抗凝治疗，随后长期服用阿司匹林预防。
我们回顾了关于急性PA闭塞可能原因的文献。这种缺血性疾病通常与心源性栓塞或小血管疾病有关。然而，在我们的患者中，未发现任何支持凝血改变或栓塞情况的因素。
在处理持续意识丧失时应考虑到这种类型的丘脑梗死。PA闭塞罕见，但需要进行脑部MRI检查以明确诊断，全面评估所有可能原因，并进行长期抗凝治疗。妊娠本身应被视为PA闭塞的一种罕见但可能的原因。
