Abstract
Artery of Percheron (AOP) infarction is a rare but clinically important cause of unilateral or bilateral thalamic infarction, commonly with a heterogeneous presentation and nonspecific neurological symptoms. In contrast to unilateral thalamic strokes, AOP infarction can present a unique hurdle for diagnostic considerations owing to its atypical clinical manifestation and the lack of widespread knowledge of this anatomic variant among clinicians. AOP infarction is associated with potentially better outcomes if it is diagnosed early, as timely and appropriate interventions can greatly affect the outcome. This case of a 39-year-old Indian female emphasizes the necessity of taking AOP infarction into account in the differential diagnosis of patients with acute symptoms of central nervous system dysfunction, particularly when initial imaging is nondiagnostic or when clinical features such as altered mental status, visual disturbances, or cognitive impairment are present. This highlights the challenges encountered in diagnosing and treating the condition while also necessitating a thorough history-taking and study of symptomatology. Early diagnosis, the use of appropriate imaging techniques, and timely treatment help increase the chances of good functional outcomes and reduce long-term neurological deficits, highlighting the need for multidisciplinary care.