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Case Reports
Lesson of the month 1: Artery of Percheron occlusion - an -uncommon cause of coma in a middle-aged man.
- James Bailey and Kayvan Khadjooi.
- Addenbrooke's Hospital, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK james.bailey5@nhs.net.
- Clin Med (Lond). 2016 Feb 1; 16 (1): 868786-7.
AbstractBilateral paramedian thalamic infarction resulting from artery of Percheron occlusion presents with a distinct clinical syndrome comprising impaired consciousness, often with vertical gaze palsy and memory impairment. This uncommon anatomical variant arises as a single artery supplying both paramedian thalami. Early recognition can be challenging in the obtunded patient, where the differential diagnosis is broad. The acute physician should consider this diagnosis in a patient presenting with unexplained coma so that emergent treatments such as thrombolysis can be employed. Early imaging with computerised tomography can often be normal; therefore the use of magnetic resonance imaging is essential in confirming the diagnosis.© Royal College of Physicians 2016. All rights reserved.
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