Abstract:

The clinical features, imaging, treatment and prognosis of 3 cases of Percheron artery infarction were analyzed retrospectively. Risk factors for cerebrovascular diseases existed in all patients. They presented acute onset, with varying degrees of disturbance of consciousness, lags in response, dysgnosia and mental changes, but without movement disorders. Two cases also presented eye movement disorders. Brain MRI showed symmetrical long T₁ and long T₂ signal in bilateral thalami and midbrain. Diffusion-weighted imaging (DWI) showed hyperintensity, and FLAIR of one case showed "V sign" in midbrain. Magnetic resonance angiography (MRA) of one case demonstrated right posterior cerebral artery (PCA) was mainly extended posterior communicating artery (PCoA), with dysplastic P1 segment, which was embryonal PCA. The clinical symptoms of 3 cases were improved significantly after cerebrovascular disease treatment. The classical clinical symptoms, symmetrical high signal in bilateral paramedian thalami on DWI and "V sign" in midbrain on FLAIR, can improve early diagnosis of Percheron artery infarction. Unilateral embryonal PCA may be underlying risk factor for Percheron artery infarction.

Key words: Infarction, posterior cerebral artery, Arterioles, Magnetic resonance imaging

摘要：

回顾分析3 例Percheron 动脉梗死患者临床资料，均存在脑血管病危险因素，临床表现为急性发病，伴不同程度意识障碍、反应迟钝、智力障碍、精神改变，无运动障碍，其中2 例伴眼球运动障碍。MRI显示双侧丘脑和中脑对称性长T₁、长T₂信号，扩散加权成像（DWI）高信号；1 例FLAIR 成像呈现中脑“V 字征”；1 例MRA 显示右侧大脑后动脉主要由后交通动脉延伸，P1 段发育不良，即胚胎型大脑后动脉。按照脑血管病治疗后临床症状均改善。提示典型临床表现、丘脑旁正中区对称性DWI 高信号和FLAIR 成像中脑“V 字征”有助于早期诊断Percheron 动脉梗死，单侧胚胎型大脑后动脉可能是Percheron动脉梗死的潜在先天性危险因素。

关键词: 梗死, 大脑后动脉, 小动脉, 磁共振成像