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Neurological Sciences

, Volume 40, Issue 1, pp 213–215 | Cite as

Artery of Percheron territory infarct due to bilateral carotid artery dissection: when anterior circulation supplies the posterior one

  • Nicola MorelliEmail author
  • Eugenia Rota
  • Massimo Nolli
  • Donata Guidetti
  • Emanuele Michieletti
Letter to the Editor
  • 38 Downloads

To the Editor,

Multiple small vessels, originating from the posterior communicating artery (PcomA) and P1 and P2 segments of the posterior cerebral arteries (PCAs), predominatly supply the thalamus. The artery of Percheron (AOP), first described by Gérard Percheron in 1973, is a rare variant of the posterior cerebral circulation, where a solitary arterial trunk supplies blood to the paramedian thalami and rostral midbrain bilaterally [1]. An ischemic stroke in the territory of an artery of Percheron usually presents with vertical gaze palsy, coma, and memory impairment.

The case of a 52-year-old man is reported. Patient’s clinical history was uneventful, although he was found in an unwitnessed comatose state, with an ischemic stroke in the AOP territory, due to a bilateral carotid artery dissection (CAD), with fetal origin of posterior cerebral arteries (f-PCA). History of a recent trauma or of a recurrent headache was negative, as well as the presence of vascular risk factors and...

Notes

Authors’ contribution

1. Study concept: N. Morelli

2. Study design: N. Morelli, Eugenia Rota

3. Data analysis/interpretation: N. Morelli, E. Rota

4. Manuscript preparation and definition of intellectual content: N. Morelli, E. Rota

5. Manuscript editing: N. Morelli, E. Rota

6. Manuscript revision/review: M. Nolli, D. Guidetti, E. Michieletti

Compliance with ethical standards

Human and animal studies have been approved by local ethics committee and therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Specific national laws have been observed, too.

Informed consent (written) of the patient has been obtained.

All data of research materials related to this paper (for example data, samples, or models) can be accessed.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Matheus MG, Castillo M (2003) Imaging of acute bilateral paramedian thalamic and mesencephalic infarcts. AJNR Am J Neuroradiol 24:2005–2008PubMedGoogle Scholar
  2. 2.
    Wu O, Schwamm LH, Sorensen AG (2011) Imaging stroke patients with unclear onset times. Neuroimaging Clin N Am 21:327–344, xi.  https://doi.org/10.1016/j.nic.2011.02.008 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Hawkes MA, Arena JE, Rollán C, Pujol-Lereis VA, Romero C, Ameriso SF, Ameriso SF (2015) Bilateral paramedian thalamic infarction. Neurologist 20:89–92.  https://doi.org/10.1097/NRL.0000000000000047 CrossRefPubMedGoogle Scholar
  4. 4.
    Qian J, Wu C, Peng J, Liu H (2017) Bilateral paramedian thalamic and midbrain infarction due to occlusion of the artery of percheronin an elderly male: a case report. Neurol Sci 38:1123–1126.  https://doi.org/10.1007/s10072-017-2860-6 CrossRefPubMedGoogle Scholar
  5. 5.
    Robertson JJ, Koyfman A (2016) Cervical artery dissections: a review. J Emerg Med 51:508–518.  https://doi.org/10.1016/j.jemermed.2015.10.044 CrossRefPubMedGoogle Scholar
  6. 6.
    Giannini N, Ulivi L, Maccarrone M, Montano V, Orlandi G, Ferrari E, Cravcenco C, Bonuccelli U, Mancuso M (2017) Epidemiology and cerebrovascular events related to cervical and intracranial arteries dissection: the experience of the city of Pisa. Neurol Sci 38:1985–1991.  https://doi.org/10.1007/s10072-017-3084-5 CrossRefPubMedGoogle Scholar
  7. 7.
    Van Overbeeke JJ, Hillen B, Tulleken CA (1991) A comparative study of the circle of Willis in fetal and adult life: the configuration of the posterior bifurcation of the posterior communicating artery. J Anat 176:45–54PubMedPubMedCentralGoogle Scholar
  8. 8.
    Bosco D, Consoli D, Lanza PL, Plastino M, Nicoletti F, Ceccotti C (2010) Complete oculomotor palsy caused by persistent trigeminal artery. Neurol Sci 31:657–659.  https://doi.org/10.1007/s10072-010-0342-1 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Neurology UnitGuglielmo da Saliceto HospitalPiacenzaItaly
  2. 2.Radiology UnitGuglielmo da Saliceto HospitalPiacenzaItaly
  3. 3.Neurology UnitSan Giacomo HospitalAlessandriaItaly
  4. 4.Department of Anesthesia and Critical CareGuglielmo da Saliceto HospitalPiacenzaItaly

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