Presentation
Patient found lying on the floor. Altered state of consciousness.
Patient Data
Age: 75 years
Gender: Female
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Bilateral and symmetrical hypodensities in the anterior and paramedian portions of the thalami, with extension towards the superior and central portion of the midbrain.
Case Discussion
A CT angiography (not shown) was done as a follow-up study which found no evidence of arterial nor venous thrombosis.
In keeping with the distribution and hypodense aspect of the lesions, the most probable diagnosis is a subacute occlusion of a Percheron artery. The differential diagnosis includes (although less probable) toxo-metabolic causes, extrapontine myelinolysis, or hypoxic-ischemic encephalopathy.
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