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A Case of Bilateral Thalamic Infarcts Involving the Artery of Percheron in the Setting of COVID-19
The artery of Percheron (AOP) is a rare anatomic variant, characterized by a single thalamoperforating artery arising from the P1 segment of the posterior cerebral artery that bifurcates to supply bilateral thalami with variable vascular supply to the midbrain. The occlusion of this artery is respon...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272890/ https://www.ncbi.nlm.nih.gov/pubmed/34277208 http://dx.doi.org/10.7759/cureus.15587 |
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author | Wilson, Branden Srinivasan, Aswin Pansuriya, Tusharkumar Alim, Salman Ali, Uzma |
author_facet | Wilson, Branden Srinivasan, Aswin Pansuriya, Tusharkumar Alim, Salman Ali, Uzma |
author_sort | Wilson, Branden |
collection | PubMed |
description | The artery of Percheron (AOP) is a rare anatomic variant, characterized by a single thalamoperforating artery arising from the P1 segment of the posterior cerebral artery that bifurcates to supply bilateral thalami with variable vascular supply to the midbrain. The occlusion of this artery is responsible for bilateral thalamic stroke with or without midbrain involvement. Since December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic. Acute ischemic stroke is a rare but known manifestation of COVID-19. There have only been a few reports of bilateral deep cerebral involvement in COVID-19 infection. In the absence of risk factors for such events, we suspect COVID-19 may have a contributory role. In this case report, we present a case of AOP infarction presenting as transient loss of consciousness, intermittent anisocoria, dysarthria, and right-sided weakness in the setting of COVID-19 infection. Given the degree of variation in clinical presentation for AOP infarcts and lack of evidence of ischemia on initial imaging studies, many patients may miss the time window for tissue plasminogen activator (tPA) administration. This case highlights the importance of timely neurological evaluation in patients presenting with COVID-19 and neurological complaints. Increased community awareness of neurological manifestations of AOP infarctions is of utmost importance as early detection and intervention improve clinical outcomes. |
format | Online Article Text |
id | pubmed-8272890 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-82728902021-07-16 A Case of Bilateral Thalamic Infarcts Involving the Artery of Percheron in the Setting of COVID-19 Wilson, Branden Srinivasan, Aswin Pansuriya, Tusharkumar Alim, Salman Ali, Uzma Cureus Internal Medicine The artery of Percheron (AOP) is a rare anatomic variant, characterized by a single thalamoperforating artery arising from the P1 segment of the posterior cerebral artery that bifurcates to supply bilateral thalami with variable vascular supply to the midbrain. The occlusion of this artery is responsible for bilateral thalamic stroke with or without midbrain involvement. Since December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic. Acute ischemic stroke is a rare but known manifestation of COVID-19. There have only been a few reports of bilateral deep cerebral involvement in COVID-19 infection. In the absence of risk factors for such events, we suspect COVID-19 may have a contributory role. In this case report, we present a case of AOP infarction presenting as transient loss of consciousness, intermittent anisocoria, dysarthria, and right-sided weakness in the setting of COVID-19 infection. Given the degree of variation in clinical presentation for AOP infarcts and lack of evidence of ischemia on initial imaging studies, many patients may miss the time window for tissue plasminogen activator (tPA) administration. This case highlights the importance of timely neurological evaluation in patients presenting with COVID-19 and neurological complaints. Increased community awareness of neurological manifestations of AOP infarctions is of utmost importance as early detection and intervention improve clinical outcomes. Cureus 2021-06-11 /pmc/articles/PMC8272890/ /pubmed/34277208 http://dx.doi.org/10.7759/cureus.15587 Text en Copyright © 2021, Wilson et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Wilson, Branden Srinivasan, Aswin Pansuriya, Tusharkumar Alim, Salman Ali, Uzma A Case of Bilateral Thalamic Infarcts Involving the Artery of Percheron in the Setting of COVID-19 |
title | A Case of Bilateral Thalamic Infarcts Involving the Artery of Percheron in the Setting of COVID-19 |
title_full | A Case of Bilateral Thalamic Infarcts Involving the Artery of Percheron in the Setting of COVID-19 |
title_fullStr | A Case of Bilateral Thalamic Infarcts Involving the Artery of Percheron in the Setting of COVID-19 |
title_full_unstemmed | A Case of Bilateral Thalamic Infarcts Involving the Artery of Percheron in the Setting of COVID-19 |
title_short | A Case of Bilateral Thalamic Infarcts Involving the Artery of Percheron in the Setting of COVID-19 |
title_sort | case of bilateral thalamic infarcts involving the artery of percheron in the setting of covid-19 |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272890/ https://www.ncbi.nlm.nih.gov/pubmed/34277208 http://dx.doi.org/10.7759/cureus.15587 |
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