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Artery of Percheron infarct: a diagnostic challenge
  1. Joana Morais,
  2. Ana Andrade Oliveira,
  3. Inês Burmester and
  4. Olga Pires
  1. Internal Medicine, Hospital de Braga, Braga, Portugal
  1. Correspondence to Dr Joana Morais; joana.morais.vnf{at}


The artery of Percheron is a rare anatomical variation that supplies thalamus and the midbrain. A stroke in this area is a rare event. The presentation varies widely, with some bizarre disturbances, like transient episodic loss of consciousness similar to coma, somnolence, cognition and memory impairment and psychosis. We report a case of a patient who presented at the emergency department with a sudden change of consciousness. During the observation, she oscillated reactive state of consciousness with obnubilation similar to coma. The first exams were normal, which include a cranial CT of the brain, and so the patient was kept under observation. The final diagnosis was only possible 24 hours later with cranial CT where an ischaemic lesion on the Percheron territory was identified. This case highlights an unusual clinic and a difficult neuroimaging stroke diagnosis of a rare condition, that is unknown to most of the physicians.

  • neurology
  • neuroimaging
  • stroke
  • warfarin therapy

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  • Contributors JM is the first author, conceived, interpreted the data and revised the final version of this draft. IB, AO and OP contributed to the analysis and interpretation of the data for this work, helped to draft the work and in its review. Also approved the final version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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