Cerebrale ischemie als oorzaak van verminderd bewustzijn: het Percheron-infarct

Abstract

Artery of Percheron infarction as an unusual cause of a reduced level of consciousness An acute onset of hemiparesis, aphasia or hemianopsia will promptly lead to the diagnosis of a stroke. However, a thalamic infarction does not always manifest with these classical symptoms due to its crucial role as a relay station between cortical brain structures, subcortical areas and the brainstem. The case of an 87-year-old woman with an altered state of consciousness due to bilateral thalamic ischemia as a result of an artery of Percheron infarction is reported. This case illustrates the clinical and diagnostic challenges in patients with an altered consciousness. The differential diagnosis is broad. One has to exclude a bilateral thalamic infarction since an early diagnosis of an ischemic stroke is crucial to initiate a proper treatment and thereby prevent morbidity and mortality.