Abstract The Artery of Percheron(AOP), named after French neurologist Dr. Gérard Percheron, is a rare anatomical variant of the thalamic blood supply, present in up to one-third of the population. This single arterial branch arises from the posterior cerebral artery (PCA) and supplies the bilateral paramedian thalamic nuclei and parts of the rostral midbrain. Among the four recognized variants of thalamic vascularization, the Type 2B configuration corresponds to the AOP. Although infarctions in the AOP territory are uncommon, their true incidence may be underestimated due to nonspecific clinical presentations and frequent misdiagnosis. Patients typically present with symptoms including confusion, somnolence, memory impairment, and vertical gaze abnormalities. We present the case of a 74 year old male with metastatic urothelial carcinoma who developed bilateral thalamic infarction with midbrain involvement consistent with an AOP stroke. This case underscores the importance of recognizing AOP infarcts in patients with unexplained altered mental status and bilateral thalamic lesions on imaging. The characteristic “V-sign” on Magnetic ResonanceImaging Fluid attenuated Inversion Recovery (MRI FLAIR) sequences indicates mid brain involvement in AOP infarction. This abstract is funded by: none
John et al. (Fri,) studied this question.