Bilateral paramedian thalamic infarction: percheron syndrome –a case report

Background: Bilateral paramedian thalamic infarction due to occlusion of the artery of Percheron is a rare but clinically significant cerebrovascular event. Occlusion of the artery of Percheron may result in bilateral infarction, often presenting with altered mental status, vertical gaze palsy, and cognitive dysfunction. Case presentation: We present a case of a 67-year-old female with poorly controlled hypertension and diabetes who developed acute neurological symptoms. Initial CT imaging was unremarkable, but MRI confirmed bilateral paramedian thalamic infarction. Clinical discussion: Anatomical variations, such as the rare presence of the Percheron artery, can significantly alter the vascular architecture, leading to unique clinical syndromes when the artery is occluded. Conclusion: This report underscores the diagnostic challenges associated with Percheron syndrome. Treatment primarily involves supportive care, risk factor management, and rehabilitation.