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Case Reports in Medicine
Volume 2010, Article ID 425734, 4 pages
http://dx.doi.org/10.1155/2010/425734
Case Report

Ischemic Stroke of the Artery of Percheron with Normal Initial MRI: A Case Report

1Intensive Care Unit, Sainte-Anne Hospital, Boulevard Sainte Anne, 83000 Toulon, France
2Department of Radiology, Sainte-Anne Hospital, 83000 Toulon, France

Received 7 November 2009; Accepted 3 February 2010

Academic Editor: Huy M. Do

Copyright © 2010 Guillaume Cassourret et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The artery of Percheron is a solitary trunk representing an uncommon anatomic variant that provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions. The clinical diagnosis is difficult because the complex anatomy causes large clinical variability. We report a case of a comatose patient with normal early head-computed tomography and magnetic resonance imaging. A bilateral paramedian thalamic infarct due to an occlusion of the artery of Percheron was revealed two days later by a new head computed tomography. To our knowledge, this is the first report in the literature of a symptomatic patient presenting an acute Percheron stroke with normal early brain magnetic resonance imaging. Our case indicates that a normal initial magnetic resonance imaging cannot formally eliminate the diagnosis of acute stroke of the artery of Percheron. We discuss the causes of noncontributive brain magnetic resonance imaging at the onset of this acute Percheron stroke and the alternative diagnosis and therapy methods.