Patient presents with altered mental status. Unenhanced CT shows discrete hypodense foci in the bilateral paramedian thalami
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Differential diagnosis includes:
Top of the basilar artery syndrome
Artery of Percheron infarct
Bilateral internal cerebral vein thrombosis
Top of the basilar artery syndrome
Artery of Percheron infarct
Bilateral internal cerebral vein thrombosis
Answer: Artery of Percheron infarct
The artery of Percheron is a rare anatomic variant where a single artery supplies both medial thalami, typically arising from the P1 segment of the PCA.
The artery of Percheron is a rare anatomic variant where a single artery supplies both medial thalami, typically arising from the P1 segment of the PCA.
Top of the basilar artery syndrome and bilateral internal cerebral vein thrombosis and be excluded by proving patent on CTA. Additionally, thrombosis of the internal cerebral veins tends to create more edema in the bilateral thalami rather than discrete focal infarct.
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