Association with clinic risk factors of Percheron artery infarction and magnetic resonance imaging involvement patterns

Taydaş, Onur; Ogul, Yasemin; Oğul, Hayri

doi:10.1007/s13760-021-01697-z

Cited by 6 publications

(2 citation statements)

References 10 publications

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“…In our case, the type III variant supplied unilaterally the territory usually covered by AOP. In AOP infarction an asymmetric topography of the infarction among the two sides has been frequently reported (nearby to 90%) 10 , so multiple combinations of anatomic variants 1,8 and variant territories 5,9,10 may be supposed.…”

Section: Discussionmentioning

confidence: 99%

Type III Percheron’s variant in thalamic-mesencephalic infarction The unexpected anastomosis

Zedde,

Grisendi,

Assenza

et al. 2023

Preprint

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Introduction. Arterial supply of thalamus is complex and highly variable. In particular, the distribution pattern of thalamoperforating arteries received attention some decades ago, but not in recent years. Methods. We are presenting the case of a 46-year-old patient with wake-up drowsiness, complex oculomotor disorder and dysarthria. The brain CT showed a subacute ischemic stroke in the right anterior thalamus and rostral midbran with a normal CTA. DSA was performed, showing a variant of thalamic supply (Percheron type III), constituted by perforating branches arising from an artery bridging the P1 segments of both PCAs. Discussion. Thalamus has a complex and variable arterial supply, mainly in the paramedian thalamic-mesencephalic arteries. The most reported variant is Percheron type IIb and supplies the paramedian thalami and the rostral midbrain. Type IIb occlusion usually causes a bilateral paramedian thalamic stroke, but rostral midbrain and anterior thalamus are involved in 57% and 19% cases. Type III variant probably prevented the bilateral extension of infarction and involved the territory of tuberothalamic and paramedian perforating arteries. Conclusions. Currently, DSA allows directly imaging variants in thalamic vascularization and better understanding the stroke mechanisms. The use of increasingly efficient angiographic techniques could help define the anatomical and hemodynamic factors involved in causing ischemic lesions in territories previously considered difficult to explore.

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Section: Discussionmentioning

confidence: 99%

Type III Percheron’s variant in thalamic-mesencephalic infarction The unexpected anastomosis

Zedde,

Grisendi,

Assenza

et al. 2023

Preprint

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“…The infarction of artery of Percheron was characterized by bilateral lesions of the paramedian thalami with or without the rostral midbrain. 16,17 (Figure 1) All patients had a standardized evaluation for their symptoms, and there were no previously diagnosed conditions affecting their cognitive and behavioral functions. Prospectively recorded variables included age, gender, previous stroke, risk factors, blood pressure, clinical findings, etiological subtypes, pathogenesis, topography of lesions on DWI, and/or FLAIR MRI.…”

Section: Methodsmentioning

confidence: 99%

The Clinical and Cognitive Spectrum of Artery of Percheron Infarction: 1-Year Follow-Up

Çetin

Kumral

Dere

2021

Can. J. Neurol. Sci.

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Objective: Survivors of patients with artery of Percheron infarction (API) often have a prolonged and disabling form of cognitive impairment that remains insufficiently characterized. We aimed to examine the clinical and cognitive features of API in the short and long term after stroke. Methods: We reviewed 6400 patients with a first-ever stroke included in the Stroke Registry between 2011 and 2021. The diagnosis of API was based on clinical diagnosis and imaging confirmation. All patients underwent neuropsychological assessment at hospital stay and 1 year after stroke. A z-score of each patients’ cognitive test point was calculated, and a z-score inferior to 2 was considered as pathological. Results: Of the 10 patients enrolled, all had cognitive impairment, consciousness, and behavioral disorders at stroke onset. Six patients had pure bilateral thalamic involvement while four had bilateral thalamic and rostral midbrain involvement. At 12 months, 50% of patients had global mental state scores 2 SD below the population mean (z-score mean ± SD, −2.17 ± 0.4). Most of the prefrontal cortex cognitive processes including executive functions such as planning and cognitive control (z-score mean ± SD, −3.92 ± 0.3), processing speed (−4.42 ± 0.5), working memory (−3.97 ± 0.3) were severely impaired at stroke onset. Especially in patients with thalamic and rostral midbrain involvement, deficiencies in executive function (z-score mean ± SD, −2.60 ± 0.4), processing speed (−2.22 ± 0.5), working (−3.76 ± 0.4), and episodic memory (−2.23 ± 0.3) continued 12 months after stroke. Conclusions: The occlusion of the artery of Percheron results in severe behavioral and cognitive disorders in the short and long term after stroke.

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Type III Percheron’s variant in thalamic-mesencephalic infarction: the unexpected anastomosis

Zedde,

Grisendi,

Assenza

et al. 2024

Surg Radiol Anat

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Association with clinic risk factors of Percheron artery infarction and magnetic resonance imaging involvement patterns

Cited by 6 publications

References 10 publications

Type III Percheron’s variant in thalamic-mesencephalic infarction The unexpected anastomosis

Type III Percheron’s variant in thalamic-mesencephalic infarction The unexpected anastomosis

The Clinical and Cognitive Spectrum of Artery of Percheron Infarction: 1-Year Follow-Up

Type III Percheron’s variant in thalamic-mesencephalic infarction: the unexpected anastomosis

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