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Clinical of Neurology, University Clinical Centre Kragujevac , Kragujevac , Serbia
Department of Neurology, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
A rare anatomic variant that arises from the P1 segment of the posterior cerebral artery (PCA) and vascularized thalami is the artery of Percheron (AOP). We present a patient with acute onset of unconsciousness that occurred as a result of bilateral thalamic infarction verified by magnetic resonance imaging (MRI). Bilateral thalamic infarction was the cause of the acute onset of dementia that we followed over the next 30 months. A 54-year-old female was admitted to the Neurological Emergency Unit because of sleepiness that began a few hours after awakening. During the examination, the patient developed a deeper disturbance of the state of consciousness lasting forty minutes with a Glasgow coma score of 3/15. Brain MRI showed symmetric bilateral thalamic infarcts and upper midbrain lesions. Mini-Mental State Examination, which is used to evaluate global cognitive function, was 19 on the sixth day of the disease course. The patient remained with vascular dementia 30 months later. The middle age of the patient, female sex, sleepiness, coma, and vascular dementia are the unique clinical features of our case. A middle-aged female patient with coma and vascular dementia that followed for 30 months has never been reported before.
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