artery of Percheron

Artery of

Percheron infarction presenting as nuclear third nerve palsy and transient loss of consciousness: a case report. Neurovascular anatomical variants supplying paramedian thalamus and mid brain as was described by Percheron [10]. (Adapted from, Artery of Percheron infarction: review of literature with a case report. Radiology and oncology. 2015 Jun 1;49 (2):141–6.Written permission was obtained from the author and the journal to use as an open access figure). a Variant I - each side perforating arteries arising from each PCA. b Variant IIa - asymmetrically arising two perforating arteries from one sided PCA. c Variant IIb - bilateral thalamic perforating arteries arising from a single common trunk (AOP). d Variant III - an arc bridging P1 segments of bilateral PCA giving rise to several perforating arteries. Vessels marked by initials: AICA - anterior inferior cerebellar artery, AOP - artery of Percheron, BA - basilar artery, MP - midbrain perforators, PCA – posterior cerebral artery, SCA - superior cerebellar artery, TP - thalamic perforators

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Percheron

artery infarction. MR angio 6 days after symptom onset, demonstrating the presence of the artery of Percheron, after regaining arterial flow. B: Basilar artery; P1: P1 segment of the posterior cerebral artery.

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Bitalamic

infarction related to occlusion of Percheron artery in patient with patent foramen-ovale. A single trunk originating from the P1 segment of PCA replaces the paramedian thalamic arteries of both sides

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Artery of

Percheron • Variations of medial thalamomesencephalic blood supply (illustration) - Ganzer Fall bei Radiopaedia

Gaillard F, Variations of medial thalamomesencephalic blood supply (illustration). Case study, Radiopaedia.org (Accessed on 04 Dec 2022) https://doi.org/10.53347/rID-35924 • CC by-nc-sa 3.0 (modified)

Radiopaedia • CC-by-nc-sa 3.0 • de

The artery of Percheron is a rare variant of the posterior cerebral circulation characterized by a solitary arterial trunk that supplies blood to the paramedian thalami and the rostral midbrain bilaterally. From the original classification of arterial patterns at the origin of the paramedian arteries for the thalamus , this variant is described as type II. Type I refers to the standard bilateral independent vascularization from the proximal segment of both posterior cerebral arteries while type III regards the existence of a communicating artery between these two independent origins, with either thalamus receiving bilateral arterial supply.

Epidemiology

The artery of Percheron is estimated to occur in up to 33% of the population . Ischemic strokes affecting this artery are thought to be at the origin of 4-18% of all thalamic strokes .

Gross anatomy

The term is used to refer to a solitary arterial trunk that branches from one of the proximal segments of either posterior cerebral artery (PCA). It supplies blood to the paramedian thalami and, most often, the rostral midbrain bilaterally . Occasionally it supplies the anterior thalamus, particularly when the thalamotuberal (or polar) arteries are absent (30-60% of cases) .

History and etymology

It is named after the French neurologist Gérard Percheron, who described it in 1973 .

Related pathology

Percheron infarct: bilateral thalamic and mesencephalic infarctions; clinically patients are often obtunded, comatose, or agitated, with associated hemiplegia or hemisensory loss