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Images in Neurology
March 2011

Delayed Sudden Coma Due to Artery of Percheron Infarction

Author Affiliations

Author Affiliations: Department of Neurology, University of Massachusetts Medical Center, Worcester.

Arch Neurol. 2011;68(3):386-387. doi:10.1001/archneurol.2010.377

A 52-year-old man was noted to display “unusual behavior” with transient agitation and blurry vision after otherwise uneventful diagnostic cardiac catheterization. Several hours after same-day discharge from the hospital, he suddenly became comatose, requiring intubation and admission to the intensive care unit. Two days later, he regained consciousness and was noted to have vertical gaze palsy and dysarthria without other neurologic deficits. Magnetic resonance imaging demonstrated bilateral acute medial thalamic ischemic strokes (Figure). Magnetic resonance angiography did not display extracranial or intracranial arterial stenosis (not shown). At 3 months' follow-up, he had only mild residual dysarthria.

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