Artery of Percheron

Artery of Percheron

The Artery of Percheron is a rare anatomical variant of the cerebral circulation in which a single arterial trunk arises from the posterior cerebral artery to supply both sides of the thalamus and the midbrain. This unique vascular configuration can have significant clinical implications, particularly in the context of stroke.

Diagram of the Circle of Willis, showing the major arteries of the brain.

Anatomy

The Artery of Percheron is a branch of the posterior cerebral artery (PCA), which is part of the Circle of Willis. In the typical cerebral circulation, each PCA gives rise to thalamoperforating arteries that supply the thalamus and midbrain on their respective sides. However, in the case of the Artery of Percheron, a single arterial trunk branches from one of the PCAs and bifurcates to supply both the left and right paramedian thalami and the rostral midbrain.

Clinical Significance

The presence of an Artery of Percheron can have important clinical consequences, especially in the event of an occlusion. A stroke affecting this artery can lead to bilateral thalamic infarction, which may result in a range of neurological deficits including altered mental status, memory impairment, and vertical gaze palsy. Diagnosis of an Artery of Percheron infarction can be challenging due to its rare occurrence and the subtlety of symptoms.

Diagnosis

Diagnosis of an Artery of Percheron infarction typically involves neuroimaging techniques such as magnetic resonance imaging (MRI) or computed tomography (CT) scans. These imaging modalities can reveal characteristic patterns of bilateral thalamic and midbrain ischemia. Recognition of this pattern is crucial for accurate diagnosis and management.

Management

Management of an Artery of Percheron infarction is similar to other types of ischemic stroke and may include thrombolysis with tissue plasminogen activator (tPA) if the patient presents within the appropriate time window. Supportive care and rehabilitation are also important components of treatment to address any resulting neurological deficits.

Related pages

• Circle of Willis
• Posterior cerebral artery
• Thalamus
• Stroke