A Rare Manifestation of Posterior Circulation Stroke: Artery of Percheron Infarction with Thalamic and Midbrain Involvement

Abstract

Background: Stroke can manifest through a range of neurological symptoms, including visual impairments, and is frequently linked to considerable disability. Strokes affecting the posterior circulation are particularly noted for their unusual and diverse presentations. This case emphasizes the critical need for the prompt identification of ocular and neurological signs, which may signal an impending stroke.
Case Report: A 50-year-old male with a medical history of hypertension and type 2 diabetes mellitus arrived at the emergency department exhibiting sudden right-sided weakness, slurred speech, and visual difficulties. MRI of the brain indicated a recent ischemic stroke located in the right thalamus, cerebral crus, and posterior lobe, accompanied by a cuneate lesion in the bilateral paramedian midbrain. Color doppler imaging of the carotid arteries showed atherosclerotic plaques with mild stenosis, indicating a possible source of ischemia. The patient received immediate treatment with antiplatelet agents, statins, antihypertensive drugs, and supportive care.
Conclusion: This case highlights the importance of being alert to stroke symptoms, particularly in individuals with risk factors such as hypertension and diabetes. Timely recognition and intervention can mitigate further neurological decline and enhance patient outcomes.