The Artery of Percheron and Etiologies of Bilateral Thalamic Stroke

Abstract

he artery of Percheron (AOP) is a unique vessel that originates from the posterior cerebral artery (PCA) to supply the T bilateral thalami. Recognition of this anatomic variant should be of practical interest to clinicians, as occlusion of the AOP remains an important cause of bilateral thalamic strokes. The first published report of bilateral thalamic infarctions has been attributed to Beauvois and Lhermitte in 1975 (1). Since then, there has been increasing acknowledgment and association of the AOPwith bilateral thalamic injury. However, this ischemic presentation still remains uncommon. A review of the literature in 2009 identified only 51 cases of AOP involving bilateral thalamic infarcts (17). Similar stroke patterns have also been recognized with other vascular etiologies, such as “top of the basilar” syndrome, as well as cerebral venous thrombosis. Therefore, distinguishing AOP occlusion from other vascular pathologies requires a thorough understanding of the anatomic, clinical, and radiographic differences in order to provide optimal therapeutic management.