A case of acute bilateral thalamic infarction presenting in a sleep-like coma after alcohol ingestion.
- Author:
Ji Eun KIM
1
;
Song Yi PARK
;
Jin Woo JEONG
;
Jae Hoon LEE
;
In Ho KWON
;
Yuri CHOI
Author Information
1. Department of Emergency Medicine, Dong-A University Hospital, Busan, Korea. capesongnew@gmail.com
- Publication Type:Case Report
- Keywords:
Thalamus;
Infarction;
Unconsciousness;
Alcoholic intoxication
- MeSH:
Alcoholic Intoxication;
Arteries;
Brain;
Cerebral Angiography;
Coma*;
Constriction, Pathologic;
Disorders of Excessive Somnolence;
Drinking;
Eating*;
Emergency Service, Hospital;
Humans;
Infarction*;
Magnetic Resonance Imaging;
Memory;
Mesencephalon;
Middle Aged;
Paralysis;
Platelet Aggregation Inhibitors;
Posterior Cerebral Artery;
Spouses;
Thalamus;
Unconsciousness;
Vertebral Artery
- From:Journal of the Korean Society of Emergency Medicine
2018;29(3):285-288
- CountryRepublic of Korea
- Language:English
-
Abstract:
The artery of Percheron is a rare anatomical variant, in which a common trunk arises from one posterior cerebral artery and then branches to supply each of the thalami and the midbrain separately. Occlusion of this artery triggers a bilateral thalamic infarction. The most commonly reported clinical findings are an altered mental status, vertical gaze palsy, and memory impairment. A 51-year-old man was transferred to the emergency department with a sudden loss of consciousness after drinking alcohol. He appeared to be sleeping deeply. His wife insisted that he had not drunk a quantity of alcohol that would render him unconscious. Magnetic resonance imaging of the brain revealed an acute, bilateral, paramedian thalamic infarction. He was admitted and treated with antiplatelet agents. On the following day, four-vessel cerebral angiography revealed stenosis of the left, distal vertebral artery. Three weeks after admission, he was discharged with persistent hypersomnia, memory impairment, and behavioral changes.
