TẮC ĐỘNG MẠCH PERCHERON: BÁO CÁO CA LÂM SÀNG NHỒI MÁU NÃO KHÓ CHẨN ĐOÁN

Abstract

Objectives: To report two cases of artery of Percheron occlusion (AOP) diagnosed and treated at the Stroke Center of Military Hospital 103, and to highlight the diagnostic challenges, imaging characteristics, and appropriate treatment strategies. Methods: Case report 1: A 56-year-old female presented 4 hours after symptom onset with a Glasgow  score of 14 and bilateral limb weakness, more prominent in the upper limbs and on the right (NIHSS 13). MRI showed bilateral thalamic infarction. Following intravenous thrombolysis, the patient improved markedly, with NIHSS 3 and mRS 0 after 72 hours. Case report 2: A 77-year-old male was admitted 9 hours after symptom onset with impaired consciousness (Glasgow score of 9) and severe neurological deficits (NIHSS 32). MRI revealed bilateral thalamic infarction with midbrain involvement. After standard ischemic stroke protocol, the patient’s condition improved to NIHSS 10 and mRS 3 after 14 days. The initial brain CT was unremarkable, contributing to diagnostic difficulty. Conclusion: AOP occlusion is a rare subtype of ischemic stroke that requires early recognition. Diffusion-weighted MRI plays a key role in establishing the diagnosis.