Bilateral Paramedian Thalamic Infarct

Yamaguchi, Toshimasa; Yakushiji, Yosuke

doi:10.1016/j.amjmed.2021.06.039

Cited by 4 publications

(7 citation statements)

References 3 publications

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“…These structures are responsible for the regulation of the sleep-wake cycle. Therefore, thalamic infarcts ca cause paresthesias or numbness, speech and cognition disturbance, memory impairment, and stupor (6). Our patient presented a motor deficit associated with consciousness discturbance like stupor.…”

Section: Discussionmentioning

confidence: 68%

“…Thus, a careful clinical examination allows the diagnosis to be suspected. Brain CT allowed to exclude the infarction involving occipital lobe (or lobes), that could suggest basilar artery occlusion, but it did revealed symmetrical ischemic lesions in both thalami and anteromedial midbrain, which were consistent with clinical presentation (13) (6). Carotid and basilar Doppler ultrasound was irrelevant.…”

Section: Discussionmentioning

confidence: 85%

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Weber’s syndrome revealing a Percheron artery infarction: a case report

Mbodji

Faye²,

Diop³

et al. 2022

Preprint

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 85%

Weber’s syndrome revealing a Percheron artery infarction: a case report

Mbodji

Faye²,

Diop³

et al. 2022

Preprint

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show abstract

“…Therefore, thalamic infarcts can cause paresthesia or numbness, speech and cognition disorders, memory impairment, and stupor. 6 Our patient presented with a motor deficit associated with a stupor‐like consciousness disorder. This anatomical variant occurs in 4%–11% of the population and infarcts of this artery account for 4%–18% of all thalamic infarcts and 0.1%–2% of all strokes.…”

Section: Discussionmentioning

confidence: 79%

“…Brain CT allowed to exclude the infarction involving the occipital lobe (or lobes), which could suggest basilar artery occlusion, but it did reveal symmetrical ischemic lesions in both thalami and anteromedial midbrain, which were consistent with clinical presentation. 6 , 13 Carotid and basilar Doppler ultrasounds were irrelevant. CT angiography was performed (arterial and venous phases), which revealed no signs of arterial or venous thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Weber's syndrome revealing a Percheron artery infarction: A case report

Mbodji

Faye

Diop

et al. 2023

Clinical Case Reports

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Key Clinical Message Weber's syndrome revealing a Percheron artery infarction is a rare clinical occurrence. Its diagnosis requires careful clinical examination and brain MRI, which is the gold standard for diagnosis. If this is not available, combined cerebral CT scan with a CT angiography of supra‐aortic arteries may be useful for the diagnosis. Abstract Percheron's artery (PA) occlusion is an uncommon type of stroke involving paramedian thalamus and/or midbrain infarction. It accounts for 4%–18% of all thalamic infarcts and 0.1%–2% of all strokes. Its clinical manifestations are variable and its mode of presentation as Weber's syndrome is exceptional due to the unusual clinical presentation.

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“…However, this is likely a conservative estimate due to the insufficient knowledge of it and limitations in the inclusion criteria [ 15 ]. AOP arising from P1 segments of the PCA supply predominantly paramedian bithalami with variable contribution to the rostral midbrain or anterolateral thalami [ 16 ]. In our studies, hypertension, smoking, diabetes mellitus, and hyperlipemia are risk factors for acute percheron infarction.…”

Section: Discussionmentioning

confidence: 99%

Acute percheron infarction: a precision learning

Zhang

Wang²,

Chen

et al. 2022

BMC Neurol

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Background So far, the diagnosis of acute artery of percheron (AOP) infarction is uncommon. In this study, patients with acute AOP infarction were studied to explore the relationship of imaging findings, clinical manifestations and prognosis of acute AOP infarction. Materials A total of 23 patients with acute AOP infarction in our institution from 2014 to 2019 were reviewed retrospectively. All cases were evaluated by computed tomography (CT) and magnetic resonance imaging (MRI). The modified Rankin scale (MRS), blood examination, electrocardiogram and transthoracic echocardiography were used for detailed clinical and prognostic evaluation. All standard risk factors for these patients were recorded. The MRS scores were performed 90 days after discharge. Results Four different types of acute AOP infarction were identified: (a) bilateral paramedian thalamic infarction (BPTI, 52%); (b) bilateral paramedian thalamic with rostral midbrain infarction (BPTRMI, 30%), (c) bilateral paramedian and anterior thalamic infarction (BPATI, 13%), and (d) bilateral paramedian thalamic with red nuclei infarction (BPTRNI, 4%). These patients had consciousness disorder, memory dysfunctions, vertical gaze paresis and mesencephalothalamic syndrome. The 65% of patients with BPTI and BPATI experienced relatively good functional recovery and could carry out daily life activities (MRS score ≤ 2). However, patients with BPTRMI may have an unfavorable outcome. Conclusions Although the clinical features are variable, DWI or ADC map can improve the diagnosis of acute AOP infarction patterns. Acute AOP occlusion requires immediate diagnosis and treatment to obtain more favorable outcome and avoid additional unnecessary procedures.

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Bilateral Paramedian Thalamic Infarct

Cited by 4 publications

References 3 publications

Weber’s syndrome revealing a Percheron artery infarction: a case report

Weber’s syndrome revealing a Percheron artery infarction: a case report

Weber's syndrome revealing a Percheron artery infarction: A case report

Acute percheron infarction: a precision learning

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