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CASE REPORT
Artery of Percheron: an unusual stroke presentation
  1. Toby Pitts-Tucker1,
  2. Jeremy Small2
  1. 1 Department of Geriatric Medicine, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK
  2. 2 Department of Radiology, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK
  1. Correspondence to Dr Toby Pitts-Tucker, tobypittstucker{at}gmail.com

Summary

An 86-year-old woman was admitted with multiple episodes of transient loss of consciousness. She was initially treated for seizures, and stroke was not considered likely. MRI on the same day of admission showed acute bilateral medial thalamic infarcts in keeping with the Artery of Percheron (AOP) territory infarcts. Investigation for polycythaemia and thrombocytosis showed JAK2 positive myeloproliferative neoplasm.

A diagnosis of AOP infarction is often missed or delayed because it is rare and presents with variable neurological symptoms. Initial imaging in the form of CT is often negative, and some report that initial MRI findings may also be normal.An awareness of a wide range of differential diagnoses alongside a multi-modality imaging approach is required to reach a diagnosis.

Although there are several other case reports of AOP infarction in the literature, this is the first to present with transient symptoms initially mistaken for seizure activity.

  • neuroimaging
  • brain stem / cerebellum
  • stroke
  • malignant and benign haematology

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Footnotes

  • Contributors Toby Pitts-Tucker conceived and drafted this article. Jeremy Small made significant contributions to its content, helped in its revision and has given approval for its publication.

  • 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.

  • Patient consent Obtained.

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

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