Artery of Percheron Infarction
Keywords:
artery of Percheron, bilateral thalamic infarction, computed axial tomography.Abstract
Introduction: The artery of Percheron infarction is a rare pathology, which is characterized by anatomical variations and difficult clinical diagnosis.
Objective: To describe a clinical case of artery of Percheron infarction.
Case report: We report the case of a 67-year-old woman who was very sleepy and did not respond satisfactorily to the questions; she had history of hypertension. A baseline clinical examination was performed revealing she was drowsy, her Glasgow showed eye opening 3, verbal response 4, motor response 5, 12/15, hyporeactive pupils, no signs of focusing. Computed axial tomography of the head with no contrast was indicated, reporting results that were proper for her age. Urinary sediment resulted non-pathological. Treatment for benzodiazepine poisoning was started with flumazenil, but the patient did not react to the treatment and worsened. Her head CT without contrast was repeated, showing hypodensities in the paramedian region of both thalami without involvement of the midbrain: the artery of Percheron infarction. Consultation was carried out with the intensive care unit to manage it. Two days later, the patient died from superimposed infection.
Conclusion: The artery of Percheron infarction presents with non-specific symptoms in the initial stage, which makes it go unnoticed in the clinical evaluation. It should be considered in a differential diagnosis in all patients with altered state of consciousness, and a normal computed axial tomography should be performed. Therefore, timely diagnosis and treatment are a must to avoid unnecessary additional procedures or even death.
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