Hacer Erdem TİLKİ, Didem ER, Lütfi İNCESU

Percheron Arter Oklüzyonuna Bağlı Akut Afazi

Talamus önemli kortikal işlevleri bütünleştiren stratejik nükleuslara sahiptir ve vasküler etkilenmeleri farklı klinik sendromlara neden olur. Bunlardan birisi bilinç kaybı, vertikal bakış paralizileri ve amnezi ile karakterli paramedian bölge infarktlarıdır. Paramedian bölge posterior serebral arterden çıkan talamoperforan arterlerce beslenir. Sayı, genişlik ve besledikleri alan açısından farklılıklar gösteren talamoperforan arterler bazan bir taraftaki posterior serebral arterden tek bir kökle çıkar ve iki taraf paramedian bölgeyi besler. Bu anatomik varyant Percheron arteri olarak isimlendirilir ve bu arterin tıkanıklığı bilateral paramedian talamik infarkta neden olur. Bu makalede afazi ile başlangıç gösteren bir Percheron arter tıkanıklığı olgusu sunulmuştur.

Anahtar Kelimeler:

Talamus, İnfarkt, Percheron arteri

Acute Aphasia Due to Percheron Artery Occlusion

Thalamus contains strategic nuclei that integrates vital cortical functions, and vascular insults to thalamus results in distinct clinical syndromes. One of these is paramedian territory infarctions that clasically characterized with decreased level of consciousness, vertical gaze paralysis and amnesia. Paramedian territory is supplied by thaamoperforating arteries that originate from posterior cerebral arteries. Thalamoperforating arteries that have great variability with respect to number, size and territorial contribution, occasionally originates from one posterior cerebral artery as a common trunk and supplies paramedian territory bilaterally. This anatomic variant is called Percheron artery, and occlusion of this artery results in bilateral paramedian thalamic infarction. In this article a Percheron artery occlusion case presenting with acute aphasia is presented.

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Caplan LR, Pessin MS, Mohr JP. Vertebrobasilar Occlusive Disease. Barnett HJM, Mohr JP, Stein BM, Yatsu FM, ed. Stroke Pathophysiology, Diagnosis, and Management. London: Churchill Livingstone;1992:443-515.
Barth A, Bogousslavsky J, Caplan LR. and Thalamic Bogousslavsky J, Caplan LR, ed. Stroke Syndromes. XXX: Cambridge University Press; :276-284. Hemorrhages. Bogousslavsky J, Regli F, Uske A. Thalamic infarcts: clinical syndromes, etiology, and prognosis. Neurology 1988;38:837-847. Guigere M, Goldman-Rakic PS.
Mediodorsal nucleus: areal, laminar, and tangential distribution of afferents and efferents in the frontal lobe of rhesus monkey. J Comp Neurol 1988;277:195-213.
Groenewegen HJ, Berendse HW. The specificity of the “nonspecific” midline and intralaminar ;17:52-56. Trends Neurosci Raphaeli G, Liberman A, Gomori JM, Steiner I. Acute bilateral paramedian thalamic infarcts after occlusion of the artery of Percheron. Neurology 2006;66(1):E7.
Bogousslavsky J, Miklossy J, Deruaz JP, et al. Unilateral left paramedian infarction of the thalamus and midbrain: a clinico-pathological study. ;49:686-694. Neurosurg Psychiatry Graff-Radford NR, Damasio H, Yamada T, et al. Non-haemorrhagic thalamic infarction. Brain 1985;108:485-516.
Karabelas G, Kalfakis N, Kasvikis K, et al. Unusual features in a case of bilateral paramedian talamik infarction. J Neurol Neurosurg Psychiatry 1985;48:186. al. Loss of psychic self activation with bithalamic infarction. Acta Neurol Scand ;83:309-316. psychique. Rev Neurol 1990;146:397-404. thalamus and behavior: effects of anatomically distinct strokes. Neurology 2006;66:1817-1823. al. Loss of psychic self-activation after paramedian ;31:1762-1765.
E, et al. Contributions of the left intralaminar and medial thalamic nuclei to memory. Arch Neurol 1992;49:1050-1058. Anteromedian, territory infarcts of the thalamus. Three variant types. Stroke 2004;35:2826-2834.
Uylings HB. Contributions of thalamic nuclei to declarative ;39:1047-1062.
Hoesen GW. Diencephalic amnesia. Brain ;11:1-25. severely impaired by combined but not by separate hippocampus. Nature 1978;273:297-298.
The syndrome of combined polar and paramedian Neurol 2005;62:1212-1216.
Bilateral paramedian talamik infarct in the presence of an unpaired talamik perforating artery. ;144(3):301-304. Fischbein NJ, et al. Artery of Percheron infarction: imaging patterns and clinical spectrum. ;31:1283-1289. infarction. Stroke
Mennemeier M, Fennell E, Valenstein Carrera E, Michel P, Bogousslavsky J. central and posterolateral Van der Werf YD, Jolles J, Witter MP, memory functioning. Cortex Graff-Radford NR, Tranel D, van Mishkin M. Memory in monkeys removal of amygdala and Perren F, Clarke S, Bogousslavsky J. thalamic infarction. Arch Roitberg BZ, Tuccar E, Alp MS. Acta Neurochir (Wien). Lazzaro NA, Wright B, Castillo M, AJNR Am J Neuroradiol