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J Korean Soc Emerg Med > Volume 29(3); 2018 > Article
Journal of The Korean Society of Emergency Medicine 2018;29(3): 285-288.
A case of acute bilateral thalamic infarction presenting in a sleep-like coma after alcohol ingestion
Ji Eun Kim1 , Song Yi Park1,2 , Jin Woo Jeong1,2 , Jae Hoon Lee1,2 , In Ho Kwon1,2,3 , Yuri Choi1
1Department of Emergency Medicine, Dong-A University Hospital, Busan, Korea
2Department of Emergency Medicine, Dong-A University College of Medicine, Busan, Korea
3Department of Emergency Medicine, Graduate School, Kangwon National University School of Medicine, Chuncheon, Korea
Correspondence  Song Yi Park ,Tel: 051-240-5590, Fax: 051-240-5309, Email: capesongnew@gmail.com,
Received: April 13, 2018; Revised: May 17, 2018   Accepted: June 8, 2018.  Published online: June 30, 2018.
ABSTRACT
The artery of Percheron is a rare anatomical variant, in which a common trunk arises from one posterior cerebral artery and then branches to supply each of the thalami and the midbrain separately. Occlusion of this artery triggers a bilateral thalamic infarction. The most commonly reported clinical findings are an altered mental status, vertical gaze palsy, and memory impairment. A 51-year-old man was transferred to the emergency department with a sudden loss of consciousness after drinking alcohol. He appeared to be sleeping deeply. His wife insisted that he had not drunk a quantity of alcohol that would render him unconscious. Magnetic resonance imaging of the brain revealed an acute, bilateral, paramedian thalamic infarction. He was admitted and treated with antiplatelet agents. On the following day, four-vessel cerebral angiography revealed stenosis of the left, distal vertebral artery. Three weeks after admission, he was discharged with persistent hypersomnia, memory impairment, and behavioral changes.
Key words: Thalamus; Infarction; Unconsciousness; Alcoholic intoxication
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