Acute bilateral paramedian thalamic and mesencephalic infarcts due to occlusion of the Percheron artery: a case report

Abstract

The thalamus and midbrain mesencephalon have a complex blood supply with a great number of feedingarteries. The blood build up of thalamus is being provided by four arteries originating from the vertebrobasilarsystem and posterior communicating artery. The paramedian thalamic artery is derived from the posteriorcerebral artery proximal P1 segment. The infarcts of arterial constitute approximately 35% of all thalamicinfarcts. However, bilateral infarctions of this region are very infrequent. Percheron artery originates from thefirst branch of the posterior cerebral artery and gives bilateral medial thalamic perforating branches. Wedescribed a patient of a 88-year-old woman with acute bilateral thalamic and midbrain infarcts due to occlusionof Percheron artery demonstrated on magnetic resonance imaging.