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Case No. 305
2013-06-03~2013-06-30
출제자 : 안성준
Hit : 496
| Period | 2013-06-03~2013-06-30 |
|---|---|
| Diagnosis | Artery of percheron infarction |
| Clinical information | 78/M , C.C : Mental change |
| Discussion | Artery of percheron infarction. DDx> Wernicke encephalopathy 사진 해설 > DWI 에서 Bilateral median thalamus와 ventral midbrain 에서 diffusion restriction 을 보이며 CT angio 에서는 Bilateral PCA ,P2 occlusion, Lt. PCA P1 significant stenosis , Lt. VA, V4 atheroma가 관찰됩니다. 양쪽 thalamus를 involve하는 것을 고려하였을 때 Venous infarction, metabolic disease, tumor 등등을 생각해 볼 수 있지만, medial thalamus와 ventral midbrain 의 특징적인 location 을 고려 하였을 때 Artery of percheron infarction으로 생각됩니다. Review>Thalamic vascular supply is classically categorized into 4 territories: anterior, paramedian, inferolateral, and posterior. The anterior territory is supplied by thepolar (or thalamotuberal) arteries, which arise from the PcomA. The paramedian territory is supplied by the paramedian (or thalamoperforating) arteries, which arise from the P1 segment of the PCA. The inferolateral territory is supplied by the thalamogeniculate arteries, which arise from the P2 segment of the PCA. The posterior territory is supplied by the posterior choroidal arteries, which arise from the P2 segment of the PCA. However, the variant of paramedian artery , so called artery of percheron can supply both the paramedian and anterior thalamic territories[1]. References 1. Lazzaro NA, Wright B, Castillo M, Fischbein NJ, Glastonbury CM, et al. (2010) Artery of percheron infarction: imaging patterns and clinical spectrum. AJNR Am J Neuroradiol 31: 1283-1289. |
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