Somnolence Revealing Bilateral Thalamic Stroke in a Patient with Vertebral Artery Dissection

Abstract

ABSTRACT Bilateral thalamic infarcts are rare presentations of stroke. They are the result of a complex combination of risk factors and a predisposing vessel distribution. The artery of Percheron, characterised by a single arterial trunk that irrigates both paramedian thalamic regions, can be occluded as a result of embolic diseases leading to bilateral paramedian thalamic infarcts. We describe a 35-year-old male patient with no relevant medical history who was admitted to hospital with somnolence lasting for 1 week. The scans revealed symmetric bilateral paramedian thalamic hypodensity consistent with bilateral thalamic stroke. Bilateral thalamic infarcts are unusual presentations of posterior circulation stroke; once they are diagnosed by an adequate neuroimaging protocol, further evaluation to define the cause is necessary.