Caruso Paola, Manganotti Paolo, Moretti Rita
Department of Clinical Neurology, University of Trieste, Trieste, Italy.
Vasc Health Risk Manag. 2016 Dec 22;13:11-14. doi: 10.2147/VHRM.S119395. eCollection 2017.
The artery of Percheron is a rare anatomical variant where a single thalamic perforating artery arises from the proximal posterior cerebral artery (P1 segment) between the basilar artery and the posterior communicating artery and supplies the rostral mesencephalon and both paramedian territories of the thalami. Almost one-third of human brains present this variant. Occlusion of the artery of Percheron mostly results in a bilateral medial thalamic infarction, which usually manifests with altered consciousness (including coma), vertical gaze paresis, and cognitive disturbance. The presentation is similar to the "top of the basilar syndrome", and early recognition should be prompted. We describe the case of a young female with this vessel variant who experienced a bilateral thalamic stroke. Magnetic resonance angiography demonstrated bilateral thalamic infarcts and a truncated artery of Percheron. Occlusion of the vessel was presumably due to embolism from a patent foramen ovale. Thrombolysis was performed, with incomplete symptom remission, cognitive impairment, and persistence of speech disorders. Early recognition and treatment of posterior circulation strokes is mandatory, and further investigation for underlying stroke etiologies is needed.
Percheron动脉是一种罕见的解剖变异，即单一丘脑穿通动脉起源于基底动脉与后交通动脉之间的大脑后动脉近端（P1段），供应中脑嘴侧以及双侧丘脑旁正中区域。近三分之一的人脑存在这种变异。Percheron动脉闭塞大多导致双侧丘脑内侧梗死，通常表现为意识改变（包括昏迷）、垂直凝视麻痹和认知障碍。其表现与“基底动脉尖综合征”相似，应尽早识别。我们描述了一名患有这种血管变异的年轻女性发生双侧丘脑卒中的病例。磁共振血管造影显示双侧丘脑梗死以及Percheron动脉截断。血管闭塞推测是由于卵圆孔未闭导致的栓塞。进行了溶栓治疗，但症状缓解不完全，存在认知障碍和言语障碍持续存在的情况。后循环卒中的早期识别和治疗至关重要，需要进一步调查潜在的卒中病因。
