Objectives
The Percheron artery (PA) is a rare variant vessel. Its acute occlusion can cause
a bilateral symmetrical thalamic stroke, clinically manifested as a sudden alteration
of consciousness that could vary from sleepiness to coma. In this paper, we illustrate
a case of acute PA occlusion in a young, pregnant woman and present a review of the
literature, focusing on the possible causes of the acute occlusion.
Methods
A 35-year-old woman, at the fourth week of pregnancy, came to the emergency department
of our hospital because of a sudden onset and persistent loss of consciousness. Brain
magnetic resonance imaging (MRI) showed a symmetrical and bilateral thalamic infarction
without evidence of other ischemic lesions, compatible with an acute PA occlusion.
Results
The patient, who showed full clinical recovery within a few hours of symptom onset,
received a short-term anticoagulant treatment followed by aspirin for long-term prevention.
Conclusions
We reviewed the literature about the possible causes of acute PA occlusion. This ischemic
condition is usually associated with cardioembolic or small-vessel disease. However,
in our patient, we did not find any element supportive for coagulative alteration
or embolyzing conditions.
Practice
The presence of this type of thalamic stroke should be considered in the management
of persistent loss of consciousness. PA occlusion is rare, but it needs a brain MRI
examination for a correct diagnosis, a narrow evaluation of all the possible causes,
and a long-term anticoagulant therapy. Pregnancy itself should constitute a rare but
possible cause of a PA occlusion.
Key Words
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Article info
Publication history
Published online: December 11, 2015
Accepted:
November 5,
2015
Received in revised form:
September 24,
2015
Received:
June 5,
2015
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.011
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
