Percheron artery infarction: a rare and challenging diagnosis. About a case.

Abstract

A 67-year-old female patient was admitted to the hospital emergency room, accompanied by her family member: her daughter reported that she was decompensated, was sleepy, and had difficulty responding to questioning; with a history of arterial hypertension (AHT). On clinical examination: drowsy, Glasgow: ocular opening 3, verbal response 4, motor response 5, 12/15; pupils hyper-reactive, no signs of focalization. A non-contrast computed axial tomography (CAT) scan of the head was requested, reporting that she was tomographically adequate for her age. As the hours passed, there was greater neurological compromise: confusion, disorientation, she stopped speaking, her gaze became fixed, and she progressed from superficial to deep coma. The head CT was repeated without contrast, reporting: hypodensities in the paramedian region of both thalami, without involvement of the midbrain; infarction in the Percheron artery. Interconsultation with the intensive care unit (ICU) was performed, and transfer to their service was indicated for management. The patient died the following day.