J Korean Soc Emerg Med.  2018 Jun;29(3):285-288. 10.0000/jksem.2018.29.3.285.

A case of acute bilateral thalamic infarction presenting in a sleep-like coma after alcohol ingestion

• Kim JE
• Park SY
• Jeong JW
• Lee JH
• Kwon IH
• Choi Y

• KMID: 2435514
• DOI: http://doi.org/10.0000/jksem.2018.29.3.285

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.

Keyword

Thalamus; Infarction; Unconsciousness; Alcoholic intoxication

MeSH Terms

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
Platelet Aggregation Inhibitors