Acute cerebral infarction due to occlusion of the artery of Percheron (AOP) is rare and poses a diagnostic challenge due to unspecific clinical symptoms. A prompt diagnosis and treatment is vital due to a potentially very serious outcome. Here we represent a healthy young woman who developed sudden headache and loss of consciousness. At admission she was unconscious with GCS of 4, pupils were unevenly dilated and poorly reactive and the plantar reflex was upward bilaterally. She had seizurelike movements in all limbs. CT of brain and CT angiography were normal but acute MRI showed bilateral paramedian thalamic diffusion restriction. The patient was treated with i.v. thrombolysis (tPA) 70 minutes after hospital arrival and recovered fully.

¹Department of Neurology, University Hospital of Iceland, Reykjavik, Iceland, ²Faculty of Medicine, University of Iceland

Correspondence: Ólafur Sveinsson, olafursv@landspitali.is

Key words: stroke, Artery of Percheron, diffusion weighted imaging, thrombolysis