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大脑后动脉丘脑穿通动脉梗死:不可漏诊的罕见病。

Artery of Percheron Infarct: ARarity Not to be Missed.

作者信息

Niazi Farheen, Naeem Sameen Bin

机构信息

Department of Neurology, Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad.

Department of Medicine, Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad.

出版信息

J Coll Physicians Surg Pak. 2017 Sep;27(9):577-578.

Abstract

Artery of Percheron (AOP) is a rare vascular variant of posterior cerebral circulation and it supplies blood to the bilateral paramedian thalami and the rostral midbrain. Artery of Percheron infarct requires a comprehensive clinical and radiological examination. It can be easily overlooked due to normal CTfindings and wide range of differential diagnosis. Classic triad of presentation is altered mental status, memory impairment and the vertical gaze palsy. We report a case of a 66-year female who had sudden onset of severe vertigo, diplopia and ataxia. Anon-contrast CTBrain was performed which was normal. Her MRI brain with diffusion weighted images (DWI) confirmed bilateral thalamic infarcts which were initially thought to be calcifications, as usually happens with diagnosing artery of Percheron infarcts. However, by reviewing and ruling out all other possible causes of such symptoms and further review of neuroimaging, lead us to the correct diagnosis.

摘要

佩谢隆动脉(AOP)是一种罕见的大脑后循环血管变异,它为双侧丘脑旁正中区域和中脑嘴侧供血。佩谢隆动脉梗死需要进行全面的临床和影像学检查。由于CT表现正常且鉴别诊断范围广泛,该病很容易被忽视。典型的三联征表现为精神状态改变、记忆障碍和垂直凝视麻痹。我们报告一例66岁女性,她突然出现严重眩晕、复视和共济失调。进行了非增强头颅CT检查,结果正常。她的头颅MRI弥散加权成像(DWI)证实双侧丘脑梗死,最初被认为是钙化,诊断佩谢隆动脉梗死时通常会出现这种情况。然而,通过回顾并排除所有其他可能导致此类症状的原因以及进一步复查神经影像学,我们得出了正确诊断。

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