Palavras-chave
Artéria
Diabetes mellitus
Ressonância
Hipoglicemia
Como Citar
Resumo
Introdução: a síndrome de Percherón é causada por lesões isquêmicas talâmicas bilaterais ocasionando uma série de anomalias clínicas como: alteração do estado de consciência, oftalmoplegia, e alterações da memória. Caso clínico: apresentamos o caso de uma mulher de 49 anos com diabetes mellitus, mau controle metabólico, episódios hipoglicêmicos e hiperglicêmicos repetitivos, que cursa com sintomatologia inespecífica, estudos imagiológicos não-invasivos documentados lesões talâmicas bilaterais. Conclusões: os quadros subagudos e isquêmicos parciais que envolvem a região paramediana do Tálamo bilateral poderiam ter alguma relação com episódios hipoglicêmicos e hiperglicêmicos repetitivos, que podem chegar a cursar com sintomatologia leve e inespecífica, o que o torna um desafio diagnóstico para a síndrome.
Referências
Polo N, García MB, Camerlingo S, Domínguez MP. Síndrome de Percheron infarto talámico bilateral: reporte de 2 casos. Rev Méd Clín Las Condes. 2019; 30(5): 383–387.
Bøgseth AØ, Soares JZ, Undseth R, Valeur J. Artery of Percheron occlusion. Tidsskr Nor Laegeforen. 2018; 138(19). English, Norwegian. doi: 10.4045/ tidsskr.18.0298
Liu J, Xiao H, Hu Z. Percheron Infarction: Is it just a rare cerebrovascular variant or a forewarning of severe multiple posterior circulation infarcts. J Stroke Cerebrovasc Dis [Internet]. 2019 [cited 2020 Dec 9]; 28(4): e27–29.
Payenok AV, Shevaha VM, Kulyk AR, Netliukh AM, Kulmatytskyi AV. Stroke in the artery of percheron territory: the two edges of one diagnosis. Wiad Lek [Internet]. 2019 [cited 2020 Dec 9]; 72(9 cz 2): 1851-1853.
Wong ML, Edlow JA. Artery of Percheron Stroke. J Emerg Med [Internet]. 2018 [cited 2020 Dec 9]; 55(1): 114–117. doi: https://doi.org/10.1016/j. jemermed.2018.02.048
Xu Z, Sun L, Duan Y, Zhang J, Zhang M, Cai X. Assessment of Percheron infarction in images and clinical findings. J Neurol Sci. 2017 Dec 15; 383: 87– 92. doi: https://doi.org/10.1016/j.jns.2017.10.033
Kichloo A, Jamal SM, Zain EA, Wani F, Vipparala N. Artery of Percheron infarction: A short review. J Investig Med High Impact Case Reports [Internet]. 2019 [cited 2020 Dec 9]; 7. doi: https://doi. org/10.1177/2324709619867355
Lin PC, Lee CW, Liu HM, Xiao FR. Acute infarction in the artery of Percheron distribution during cerebral angiography: A case report and literature review. J Radiol Case Rep [Internet]. 2018 [cited 2020 Dec 9]; 12(7): 1-9. doi: 10.3941/jrcr.v12i7.3318
Pitts-Tucker T, Small J. Artery of Percheron: an unusual stroke presentation. BMJ Case Rep. 2018 Mar 28; 2018: bcr2017222185. doi: 10.1136/bcr2017-222185
Sandvig A, Lundberg S, Neuwirth J. Artery of Percheron infarction: A case report. J Med Case Rep [Internet]. 2017 Dec 12 [cited 2020 Dec 9]; 11(1): 221.
Jodar M, Martos P, Fernández S, Canovas D, Rovira A. Neuropsychological profile of bilateral paramedian infarctions: Three cases. Neurocase [Internet]. 2011 [cited 2020 Dec 9]; 17(4): 345–352. doi: https://doi.org/10.1080/13554794.2010.509324
Ince B, Asan F. Persistent anterograde amnesia due to the artery of Percheron occlusion: a case report. Neurocase [Internet]. 2018 Mar 4 [cited 2020 Dec 9]; 24(2): 95–97. doi: https://doi.org/10.1080/1355 4794.2018.1458884
Zhou Y, Fox D, Anand A, Elhaj A, Kapoor A, Najibi F, et al. Artery of Percheron infarction as an unusual cause of Korsakoff’s syndrome. Case Rep Neurol Med [Internet]. 2015 [cited 2020 Dec 9]; 2015: 1–6. doi: https://doi.org/10.1155/2015/927809
Caruso P, Manganotti P, Moretti R. Vascular health and risk management dovepress complex neurological symptoms in bilateral thalamic stroke due to Percheron artery occlusion. Vasc Health Risk Manag [Internet]. 2017 [cited 2020 Dec 9]; 13–24. doi: http://dx.doi.org/10.2147/VHRM.S119395
O’Reilly MK, Mogensen MA. Artery of Percheron stroke: Imaging and clinical findings. PM&R [Internet]. 2019 [cited 2020 Dec 9]; 11(10): 1135– 1138. doi: https://doi.org/10.1002/pmrj.12210
Chang Y-M, Fan Y-K. Artery of Percheron occlusion in an elderly male: A case report. J Clin Med Res [Internet]. 2015 [cited 2020 Dec 9];7(2): 126–128. doi: http://dx.doi.org/10.14740/jocmr2009w
DiFrancesco JC. Artery of Percheron ischaemic stroke revealed by brain MRI DWI/ADC sequences. BMJ Case Rep [Internet]. 2017 [cited 2020 Dec 9]; 2017:bcr2017223092. doi: 10.1136/bcr-2017- 223092
Abdelrasoul AA, Elsebaie NA, Gamaleldin OA, Khalifa MH, Razek AAKA. Imaging of Brain Infarctions. J Comput Assist Tomogr [Internet]. 2019 [cited 2020 Dec 9]; 43(3): 443–451. doi: 10.1097/RCT.0000000000000865
Garcia-Grimshaw MA, Peschard-Franco M, Gutierrez-Manjarrez FA. Bilateral thalamic ischemic stroke secondary to occlusion of the artery of Percheron. Cureus [Internet]. 2018 [cited 2020 Dec 9];10(5). doi:10.7759/cureus.2676
Puri PR, Sijapati A. Bilateral internuclear and internal ophthalmoplegia due to artery of Percheron infarction. Clin Case Reports [Internet]. 2017 Mar [cited 2020 Dec 9]; 5(3): 280–284. doi: https://doi. org/10.1002/ccr3.837
Oliveira GDP, Truzzi G, Lima FCB, Coelho FMS. A rare differential diagnosis of excessive daytime sleepiness - Artery of Percheron territory infarct. Sleep Sci. 2018 Jan-Feb;11(1): 25-27. doi: 10.5935/1984-0063.20180006
Li X, Agarwal N, Hansberry DR, Prestigiacomo CJ, Gandhi CD. Contemporary therapeutic strategies for occlusion of the artery of Percheron: a review of the literature. J Neurointerv Surg. 2015 Feb; 7(2): 95-98. doi: http://dx.doi.org/10.1136/ neurintsurg-2013-010913
Kuybu O, Tadi P, Dossani RH. Posterior cerebral artery stroke. 2022 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 30335329.
De la Cruz-Cosme C, Márquez-Martínez M, AguilarCuevas R, Romero-Acebal M, Valdivielso-Felices P. Síndrome de la arteria de Percheron: variabilidad clínica y diagnóstico diferencial. Rev Neurol. 2011; 53(04): 193-200. doi: 10.33588/rn.5304.2011084
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Luis Carlos Avellaneda-Curcho, Danna Lisbeth Camacho, Keidwin Geovanny Pérez-Hostia, Duvier Fabián Meza-Fandiño, Ledmar Jovanny Vargas-Rodríguez, Julián Cubillos-Vega, Marco Antonio Rojas-Gutiérrez