EC Clinical and Medical Case Reports

Arterial thromboembolic events are actually described as complications of COVID-19 in both acute and post-COVID phases. The artery occlusion Percheron (AOP) occasioning bithalamic infarction is rarely described in this context. A 44-year-old woman with a history of hypertension and obesity, not vaccinated against Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was admitted for status epilepticus. She was comatose requiring invasive mechanical ventilation. Asymmetric reactivity pupilla was noted with mydriasis of the right on. At the resumption of the interrogation, the family reported a flu-like syndrome two months ago. Serology COVID-19 confirmed previous immunity. Rt-PCR was negative. Thoracic CT showed suitable sequelae of COVID-19 lesions. A post-COVID19 thromboembolic complication was suspected. Cerebral angio MRI showed bithalamic hypersignal lesions without hemorrhagic stigmata and without enhancement related to acute ischemic nature. The patient was given atorvastatin, antiplatelet aspirin and curative anticoagulagulation. Clinical improvement was noted and she was extubated. However, she remained sleepy with an apathetic state, an inappropriate verbal response and memory disorders.

Although this is a rare anatomical variant, the occlusion of the Percheron artery must be suspected in front of a paramedic thalamic infarction. Complexity of clinical manifestations explains difficulty of early diagnosis.

Keywords: Artery of Percheron; Stroke; Thalamic Stroke; Covid-19; Bilateral Thalamic Stroke; Atypical Stroke; Stroke and Covid-19; Post COVID19-Syndrome

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