Artery of Percheron infarction: a rare cause of somnolence in a patient with sepsis and atrial fibrillation

Artery of Percheron (AOP) occlusion is a rare cause of ischemic stroke characterized by bilateral para-median thalamic infarcts. It usually presents with altered mental status, hyper-somnolence and ocular movement disorders. Here, we report a case of cardio-embolic AOP infarction in a 72-year-old man with sepsis and new-onset atrial fibrillation. Early diagnosis is challenging, but diffuse-weighted magnetic resonance imaging demonstrates the lesion in the acute setting. Anticoagulation therapy was started and patient’s mental status gradually improved.