IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-6-8-11622 Original Research Paper A SYSTEMATIC REVIEW ON ARTERY OF PERCHERON INFARCTION Priyanka Dr. J. Salma sulthana Dr. Ch. Archana Dr. August 2017 6 8 01 02 ABSTRACT

  Occlusion of the artery of Percheron (AOP) causes a bilateral paramedian thalamic infarction with or without midbrain infarction. AOP arising as a single unpaired trunk from posterior vertebral artery( P1 ) supplying the bilateral paramedian thalami and rostral midbrain. The clinical presentation of artery of Percheron usually presents with three main symptoms, which are found in patients with bilateral paramedian thalamic strokes. These are vertical gaze palsy (65%) is a conjugate, bilateral limitation of the eye movements in up gaze and/or down gaze, memory impairment (58%) is a unusual forgetfulness, may not be able to remember new events, recall one or more memories of the past, or both and coma (42%) is a state of unconsciousness where a person is unresponsive and cannot be woken. Bilateral paramedian thalamic lesions are often accompanied by rostal midbrain lesions, producing a “mesencephalothalamic” or “thalamopeduncular” syndrome. In addition to the mentioned triad, the syndrome is characterized by other oculomotor disturbances, hemiplegia, cerebellar ataxia and movement disorders. The etiopathogenesis includes occlusion of the artery of Percheron produces paresis of upward gaze and drowsiness and often abulia. The risk factors includes patient foramen ovale, atherosclerosis, hypercoagulable state, atrial fibrillation, intracardiac clot and severely reduced left ventricular function.  Diagnosis of an artery of Percheron infarction is critical for directing the appropriate time sensitive management and they include magnetic resonance imaging (MRI) usually allows visualization of the initial cases of acute cerebrae ischemia and is used in stroke centers as the primary or early secondary imaging modality.  Patients with ischemic stroke are thrombolysed intravenous (applied alteplase). Endovascular revascularization applies thrombolytic agents directly into the thrombus or mechanically extracts the cloth. Mechanical trombectomy is considered in patients with a diagnosis of acute stroke, who have an occlusion of a treatable intracranial artery.