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Thalamic warning syndrome and the artery of Percheron
  1. Ângelo Fonseca1,
  2. Joana Lima2,
  3. Cristina Duque1 and
  4. Luís Ribeiro1
  1. 1 Neurology Department, Hospital Pedro Hispano, Matosinhos, Portugal
  2. 2 Neuroradiology Department, Hospital Pedro Hispano, Matosinhos, Portugal
  1. Correspondence to Dr Ângelo Fonseca; angelofonseca.med{at}gmail.com

Abstract

Stroke warning syndromes manifest as brief, recurring episodes of focal neurological deficits that precede definitive brain ischaemia. Although the mechanisms remain unclear, intermittent hypoperfusion in specific vascular territories may explain these phenomena. A man in his 60s with vascular risk factors experienced recurrent episodes of sudden loss of consciousness. Initial imaging and tests were normal, excluding other potential causes. MRI revealed bilateral thalamic infarction and the presence of an artery of the Percheron variant. We propose ‘thalamic warning syndrome’ as a new term for this clinical presentation, characterised by recurrent transient loss of consciousness and a high risk of subsequent thalamic infarction. Early recognition of this syndrome can aid in the initial management and prognosis of similar cases, potentially preventing more severe neurological impairments.

  • Stroke
  • Neurology
  • Neuroimaging
  • Emergency medicine
  • Anatomic Variation

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: AF, JL, CD and LR. The following authors gave final approval of the manuscript: All authors gave final approval of the manuscript.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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