MacLellan Adam, Boyle Karl
Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5, Canada.
Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5, Canada.
J Stroke Cerebrovasc Dis. 2017 Aug;26(8):e170-e171. doi: 10.1016/j.jstrokecerebrovasdis.2017.05.017. Epub 2017 Jun 7.
We aimed to report a novel case of hyperacute computed tomography (CT) perfusion imaging abnormalities in artery of Percheron infarction.
We described a case of a 74-year-old man who presented acutely to the emergency room with witnessed sudden onset altered level of consciousness.
Although initial hyperacute CT brain imaging was reported as normal, subsequent magnetic resonance imaging revealed bilateral paramedian thalamic infarction. A retrospective review of CT perfusion imaging revealed perfusion mismatch in the bilateral thalami, which was not recognized in the hyperacute setting.
Artery of Percheron occlusion is a well-described cause of bilateral paramedian thalamic infarction, but to date, we have not identified any reports of perfusion imaging abnormalities in the hyperacute setting. This case emphasizes the important role of perfusion imaging when clinical presentation is not typical for ischemic stroke, but is suspected, given an acute onset; its recognition may have led to the consideration of thrombolysis acutely in this case (stroke chameleon).
我们旨在报告1例Percheron动脉梗死超急性计算机断层扫描（CT）灌注成像异常的新病例。
我们描述了1例74岁男性患者，他突然急性发作意识水平改变，被紧急送往急诊室。
尽管最初的超急性头颅CT成像报告显示正常，但随后的磁共振成像显示双侧丘脑旁正中梗死。对CT灌注成像的回顾性分析显示双侧丘脑存在灌注不匹配，这在超急性情况下未被识别。
Percheron动脉闭塞是双侧丘脑旁正中梗死的一个已被充分描述的病因，但迄今为止，我们尚未发现任何关于超急性情况下灌注成像异常的报告。该病例强调了在临床表现不典型但急性起病怀疑为缺血性卒中时，灌注成像的重要作用；对其的识别可能会促使在该病例中急性考虑溶栓治疗（卒中变色龙）。
