Bilateral Thalamic And Midbrain Infarcts: A Case Of Percheron’s Artery Occlusion.

Abstract

The variant artery of Perceron could be a rare cause of multiple infarcts in the posterior circulation. An unusual case of multiple ischemic brain infarcts with specific anatomical distribution Is presented. A 58-year-old Caucasian man was admitted to the hospital because of confusion, bilateral ptosis and bilateral external and internal ophthalmoplegia since 48 hours. He had history of metallic mitral valve since 2 years treated with warfarin, Brain imaging reveals symmetric bilateral paramedian thalamic and periaqueductal midbrain ischemic lesions. Percheron’s artery occlusion could lead to bilateral paramedian thalamic and midbrain infarcts The symmetric distribution of infarcts in our patient should be explained by the existence of the variance of Perceron in the blood supply network. The mirror damages in the thalamus and midbrain have to bring suspicion and direct the differential diagnosis which should be taken into consideration in the differential diagnosis especially in cases with cardiogenic emboli.