Answer for BIR CoW 05 Aug 2018
ARTERY OF PERCHERON INFARCT
Findings
Bilateral foci of recent ischaemia with restricted diffusion involving paramedian thalami and mesencephalic mid brain.
Discussion
Artery of Percheron infarct presents with variety of signs and symptoms collectively termed the paramedian thalamic syndrome, it is a type of posterior circulation infarction Bilateral paramedian thalamic involvement is usually characterised by a triad of altered mental status, vertical gaze palsy, and memory impairment When also accompanied by rostral midbrain lesions, a mesencephalic or thalamo peduncular syndrome occurs , which includes other oculomotor disturbances, hemiplegia, cerebellar ataxia, and movement disorder, along with a triad mentioned above. Artery of Percheron is a relatively rare anatomical variant, blood supply of thalami is from thalamo striate perforators , which arise from proximal portion of PCAs. First each side perforators arising separately from corresponding PCAs,second is perforators arising directly from an arch joining proximal portion of PCA and third, one of the PCA proximal portion giving a common artery which gives perforator branches to bilateral thalami is called ARTERY OF PERCHERON , occlusion of which can give rise to simultaneous bilateral thalami infarct.
Findings
Bilateral foci of recent ischaemia with restricted diffusion involving paramedian thalami and mesencephalic mid brain.
Discussion
Artery of Percheron infarct presents with variety of signs and symptoms collectively termed the paramedian thalamic syndrome, it is a type of posterior circulation infarction Bilateral paramedian thalamic involvement is usually characterised by a triad of altered mental status, vertical gaze palsy, and memory impairment When also accompanied by rostral midbrain lesions, a mesencephalic or thalamo peduncular syndrome occurs , which includes other oculomotor disturbances, hemiplegia, cerebellar ataxia, and movement disorder, along with a triad mentioned above. Artery of Percheron is a relatively rare anatomical variant, blood supply of thalami is from thalamo striate perforators , which arise from proximal portion of PCAs. First each side perforators arising separately from corresponding PCAs,second is perforators arising directly from an arch joining proximal portion of PCA and third, one of the PCA proximal portion giving a common artery which gives perforator branches to bilateral thalami is called ARTERY OF PERCHERON , occlusion of which can give rise to simultaneous bilateral thalami infarct.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
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Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!