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Bilateral Paramedian Thalamic and Mesencephalic Infarcts in a Newborn Due to Occlusion of the Artery of Percheron

Department of Medicine, The George Washington University Medical Center, Washington, DC

David T. Hsieh, MD

Department of Neurology, Children's National Medical Center, Washington, DC, dhsieh{at}cnmc.org

L. Gilbert Vezina, MD

Department of Neuroradiology, Children's National Medical Center, Washington, DC

Taeun Chang, MD

Department of Pediatrics, Inova Fairfax Hospital, Fairfax, Virginia

Bilateral paramedian thalamic and mesencephalic infarcts are infrequently reported in adults, and to our knowledge, has never been reported in a child. The presumed etiology is an occlusion of the artery of Percheron, an uncommon vascular variation, in which a single common trunk from one of the P1 segments of the posterior cerebral artery provides bilateral irrigation to the paramedian thalami and midbrain. Bilateral paramedian thalamic and mesencephalic infarcts in adults are associated with symptoms of decreased arousal, vertical gaze paresis, mood changes, and memory difficulties. Although some improvement of these symptoms does occur, complete recovery is rare. We present here a full-term male neonate, whose right-hand sided clonic seizures on day-of-life 2 prompted neuroimaging, which revealed bilateral paramedian thalamic and mesencephalic infarcts, suggestive of an occlusion of the artery of Percheron.

Key Words: neonate • stroke • artery of Percheron • posterior cerebral artery

Journal of Child Neurology, Vol. 24, No. 2, 219-223 (2009)
DOI: 10.1177/0883073808322672


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