African Health Sciences
Makerere University Medical School
Vol. 21, No. 1, 2021, pp. 166-171
Bioline Code: hs21034
Full paper language: English
Document type: Research Article
Document available free of charge
African Health Sciences, Vol. 21, No. 1, 2021, pp. 166-171
© Copyright 2021 - Rissardo JP et al.
Isolated acute pseudobulbar palsy with infarction of artery of percheron: case report and literature review|
Rissardo, Jamir Pitton & Caprara, Ana Fornari
Introduction: Pseudobulbar palsy (PBP) is characterized by supranuclear lesions in the corticobulbar pathway. Neoplasia,
inflammatory, demyelinating, and stroke are possible etiologies of this disorder.
Case report: We report an elderly female who presented with dysarthria. She was dysarthric with a hypernasal voice, no
apraxia or aphasia was observed. Tongue movements were slow with limited amplitude. Her soft palate dropped bilaterally;
gag reflex was present. Also, she reported swallowing difficulty and choking with her saliva. Bilateral vertical and horizontal
gaze were intact to either voluntary or oculocephalic movements. A cranial CT scan was suggestive of artery of Percheron
(AOP) infarction. Brain magnetic resonance imaging showed hypersignal on diffusion-weighted and T2-weighted images
and hyposignal on apparent diffusion coefficient in both thalami. CT angiography scan revealed an AOP originating from
the left posterior cerebral artery. The swallowing study with a videofluoroscopic demonstrated oral and pharyngeal phases
with severe dysfunction.
Conclusion: To the authors’ knowledge, there are two cases of individuals with artery of Percheron infarction who developed
PBP associated with other clinical syndromes. Still, isolated PBP following infarction of Percheron’s artery was not
reported. We hypothesized that the PBP may have occurred because of the existence of vascular territory variations in the
perforating arteries that arise from the AOP.
Pseudobulbar palsy; thalamus; infarction.