The Percheron artery syndrome, case report and literature review


  • Sebastian Leon Vallejo ISSSTE
  • Perla Karina Anzures-Gómez Departamento de medicina interna Hospital Regional ISSST
  • César Camacho-Becerra Departamento de medicina interna Hospital Regional ISSSTE
  • Daniel Reyes-Ortega Departamento de medicina interna Hospital Regional ISSSTE
  • Luis Humberto Torres-Pérez Departamento de medicina interna Hospital Regional ISSSTE
  • Gustavo González-González Departamento de neurología Hospital Regional ISSSTE



Percheron syndrome, Thalamus, posterior cerebral artery, stroke


The relevance of this clinical case is based on the fact that the timely diagnosis of cerebral vascular disease is centered on delimiting the damage once it has been diagnosed, trying at all times to identify areas of oligohemia and penumbra. Although this is a public health problem, the greater the accessibility to information on complex clinical manifestations with a neurological examination approach, the more tools colleagues will have, the better the therapeutic approach will be able to improve it.


An unusual clinical case of stroke is reported, as well as a review of the literature, taking into account that Percheron's artery was first described in 1973 by Gérard Percheron as an anatomical perforating thalamus variant, which is not so infrequent, present in up to 11 to 33% of the population, regularly underdiagnosed in our environment, recalling that the irrigation of the anterior and inferior midbrain and thalamus is given by the internal carotid artery while the medial, lateral and posterior territories are irrigated by the vertebrobasilar system.


This thalamopeduncular syndrome due to Percheron's artery occlusion is expressed as a bilateral medial thalamic infarction that generally presents with the triad of alteration of the awake state at various levels including coma, sudden partial or total paresis of the vertical gaze, impairment of cognition and memory.


1. Pérez Pan Art MI, Sierra Bergua B. Artery of Percheron in the Differential Diagnosis of Acute Altered Mental Status. Case Rep Med. 2021;2021:5583248.
2. Caruso P, Manganotti P, Moretti R. Complex neurological symptoms in bilateral thalamic stroke due to Percheron artery occlusion. Vasc Health Risk Manag. 2017;13:11-4.
3. Kuybu O, Tadi P, Dossani RH. Posterior Cerebral Artery Stroke. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [citado 8 de junio de 2022]. Disponible en:
4. Wong ML, Edlow JA. Artery of Percheron Stroke. J Emerg Med. julio de 2018;55(1):114-7.
5. Navas-Alcantara MS, Castilla-Guerra L, Álvarez Suero J, Carmona González E. [Percheron artery syndrome]. Med Clin (Barc). 21 de agosto de 2015;145(4):184.
6. Vasconcellos LF, Tiel C, Sudo FK, Moreira DM, Engelhardt E. Percheron thalamopeduncular syndrome with cervical dystonia: A case report. Dement Neuropsychol. diciembre de 2016;10(4):365-9.
7. Snyder HE, Ali S, Sue J, Unsal A, Fong C, Deng Z. Artery of Percheron infarction with persistent amnesia: a case report of bilateral paramedian thalamic syndrome. BMC Neurol. 8 de octubre de 2020;20(1):370.
8. Weerasinghe WS, Kularatne S a. M, Pathirage LPMMK. Para median thalamic syndrome due to occlusion of the artery of Percheron: A rare case of stroke. Ceylon Med J. 31 de marzo de 2019;64(1):30-1.
9. Arauz A, Patiño-Rodríguez HM, Vargas-González JC, Arguelles-Morales N, Silos H, Ruiz-Franco A, et al. Clinical spectrum of artery of Percheron infarct: clinical-radiological correlations. J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. junio de 2014;23(5):1083-8.
10. Yang FY, Hung JL, Lin SK. Percheron Artery-Plus Syndrome: A Syndrome Beyond Stroke Chameleon. J Nippon Med Sch Nippon Ika Daigaku Zasshi. 2021;88(4):375-9.
11. Ince B, Asan F. Persistent anterograde amnesia due to the artery of Percheron occlusion: a case report. Neurocase. abril de 2018;24(2):95-7.
12. Oliveira G da P, Truzzi G, Lima FCB, Coelho FMS. A rare differential diagnosis of excessive daytime sleepiness - Artery of Percheron territory infarct. Sleep Sci Sao Paulo Braz. febrero de 2018;11(1):25-7.
13. Lazzaro NA, Wright B, Castillo M, Fischbein NJ, Glastonbury CM, Hildenbrand PG, et al. Artery of percheron infarction: imaging patterns and clinical spectrum. AJNR Am J Neuroradiol. agosto de 2010;31(7):1283-9.
14. Gonçalves DB, Barreira RP, Torres TZM, Correa BM, Rossette VM, Marques T da C, et al. Vertical one-and-a-half syndrome in a patient with pecheron artery ischemia: A case report. Radiol Case Rep. diciembre de 2021;16(12):3908-10.
15. Garcia-Grimshaw MA, Peschard-Franco M, Gutierrez-Manjarrez FA. Bilateral Thalamic Ischemic Stroke Secondary to Occlusion of the Artery of Percheron. Cureus. 23 de mayo de 2018;10(5):e2676.



How to Cite

Leon Vallejo, S., Anzures-Gómez, P. K. ., Camacho-Becerra, C. ., Reyes-Ortega, D. ., Torres-Pérez, L. H. ., & González-González, G. . (2022). The Percheron artery syndrome, case report and literature review. Archivos De Neurociencias, 28(1).



Case report

Most read articles by the same author(s)