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Artery of Percheron Infarction as an Unusual Cause of Coma: Three Cases and Literature Review

Zappella, Nathalie, Merceron, Sybille, Nifle, Chantal, Hilly-Ginoux, Julia, Bruneel, Fabrice, Troché, Gilles, Cordoliani, Yves-Sebastien, Bedos, Jean-Pierre, Pico, Fernando, Legriel, Stephane·2014·Neurocritical Care
DOI 10.1007/s12028-014-9962-2
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Abstract

Objective Stroke due to occlusion of the artery of Percheron (AOP), an uncommon anatomic variant supplying the bilateral medial thalami, may raise diagnostic challenges and cause life-threatening symptoms. Our objective here was to detail the features and outcomes in three patients who required intensive care unit (ICU) admission and to review the relevant literature. Methods Description of three cases and literature review based on a 1973-2013 PubMed search. Results Three patients were admitted to our ICU with sudden-onset coma and respiratory and cardiovascular dysfunctions requiring endotracheal mechanical ventilation. Focal neurological deficits, ophthalmological signs (abnormal light reflexes and/or ocular motility and/or ptosis), and neuropsychological abnormalities were variably combined. Initial CT scan was normal. Cerebral MRI demonstrated bilateral paramedian thalamic infarction, with extension to the cerebral peduncles in two patients. Consciousness improved rapidly and time to extubation was 1-4 days. All three patients were discharged alive from the hospital and two had good 1-year functional outcomes. Similar clinical features and outcomes were recorded in the 117 patients identified in the literature, of whom ten required ICU admission. Conclusions Bilateral paramedian thalamic stroke due to AOP occlusion can be life threatening. The early diagnosis relies on MRI with magnetic resonance angiography. Recovery of consciousness is usually rapid and mortality is lo…

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Research works printed but not linked: 30

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Metadata

Authors
Zappella, N., Merceron, S., Nifle, C., Hilly-Ginoux, J., Bruneel, F., Troché, G., Cordoliani, Y.-S., Bedos, J.-P., Pico, F., & Legriel, S.
Venue
Neurocritical Care
Publisher
Springer Science and Business Media LLC
Published
2014-02-25
Volume
20
Issue
3
Pages
494-501
ISSN
  • 1541-6933
  • 1556-0961
DOI
10.1007/s12028-014-9962-2
Cited by
36
References
0
Language
en
Licence
www.springer.com/tdm (tdm)

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CoChat. (2026). Citation check: Artery of Percheron Infarction as an Unusual Cause of Coma: Three Cases and Literature Review. https://app.cochat.ai/papers/10.1007/s12028-014-9962-2
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Zappella, N., Merceron, S., Nifle, C., Hilly-Ginoux, J., Bruneel, F., Troché, G., Cordoliani, Y.-S., Bedos, J.-P., Pico, F., & Legriel, S. (2014). Artery of Percheron Infarction as an Unusual Cause of Coma: Three Cases and Literature Review. Neurocritical Care. https://doi.org/10.1007/s12028-014-9962-2