伴有一侧胚胎型大脑后动脉的Percheron动脉梗死二例临床与影像分析

目的 Percheron动脉属于丘脑穿动脉的一种少见的先天变异,伴有一侧胚胎型大脑后动脉的Perch eron动脉梗死报道罕见.我们报告2例,旨在提高认识以利于早期诊断和治疗.方法 回顾性分析2例Percheron动脉梗死的临床表现、影像特征、治疗及预后.结果 1例急性昏迷,1例发作性视物不清后意识不清合并眼球垂直运动障碍.2例磁共振弥散加权成像(DWI)示双侧丘脑旁正中高信号,其中1例合并中脑“V”字型高信号；2例右侧大脑后动脉(PCA) P1段均显示发育不良,即胚胎型PCA.结论 典型的临床症状、丘脑旁正中部对称DWI高信号及中脑“V”字征有助于Percheron动脉梗死的诊断及治疗.一侧胚胎型PCA可能是Percheron动脉梗死的潜在变异因素.

Clinical and imaging characteristics of Percheron artery infarction with unilateral embryonic posterior cerebral artery

Objective Percheron artery is an uncommon anatomic variant. Percheron artery infarction with unilateral embryonic posterior cerebral artery ( PCA ) was rarely reported.The aim of this study was to characterize the clinical and imaging patterns of Percheron artery infarction with the unilateral embryonic PCA for early diagnosis and treatment.Methods Clinical and imaging data of 2 patients with Percheron artery infarction were reviewed retrospectively.Results Two patients presented acute coma and one had paroxysmal blurred before coma.On neurological examinations,one patient had vertical gaze palsy besides two were unconsciousness. MRI showed symmetrical high signal intensity on diffusion weighed imaging (DWI) in bilateral paramedian thalami in two patients and a distinct pattern of V-shaped hyperintensity on DWI and FLAIR was present on the midbrain in one patient. Digital subtraction angiography and magnetic resonance angiography demonstrated unilateral embryonic PCA in two patients.Conclusions The classical clinical symptoms,symmetrical high signal in bilateral paramedian thalami and V-shaped sign in midbrain on DWI can improve recognition,evaluation and management of Percheron artery infarction.The unilateral embryonic PCA may be underlying risk factor of Percheron artery infarction.