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Acute vascular dementia with bi‐thalamic infarction due to the artery of Percheron occlusion
Author(s) -
Suen Mengfan,
Zhang Qian,
Chen Qidong,
Xu Jun
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.040326
Subject(s) - medicine , cardiology , infarction , occlusion , vascular dementia , dementia , cerebral infarction , magnetic resonance imaging , posterior cerebral artery , stroke (engine) , ejection fraction , myocardial infarction , radiology , ischemia , middle cerebral artery , heart failure , disease , mechanical engineering , engineering
Background Previous studies reported the altered mental status and behavioral amnesic impairment were the dominated clinical findings in patients with bi‐thalamic paramedian infarction only due to the occlusion of the artery of Percheron(AOP). However, the clinical features of multidomain cognitive impairment because of bi‐thalamic paramedian infarction need to be clarified. Method We report a 72 year old male with a history of hypertension who presented an acute vascular dementia with a multidomain cognitive impairment including memory, attention, orientation. Laboratory test results were not remarkable. Brain magnetic resonance imaging (MRI) revealed a bi‐thalamic symmetrical paramedian infarction. Large arterial computed tomography angiography (CTA) showed the thinner right vertebrobasilar artery and atherosclerotic plaques in the beginning of both internal carotid arteries and the right subclavain artery. Transthoratic echocardiograp‐ ‐hy revealed left ventricular diaslolic dysfunction with ejection fraction of 60%. 24‐hour dynamic eletrocardiogram(Holter) revealed paroxymol atrial tachycardia. However, there was no evidence of cardioembolism. Result The diagnosis of cerebral infarction that causes vascular dementia with a presumed occlusion of the artery of Percheron resulting from atherosclerosis was made and the treatment of antiplatelate and improving cognition was provided. Conclusion This case illustrates vascular dementia resulting from bi‐thalamic paramedian infarction deserves clinical attention.