Stroke Overview

(Left) Coronal oblique graphic

of the rostral basilar artery

shows (L) the typical arterial

supply to the medial thalami

by multiple PCA and basilar tip

perforators. The anatomic

variant, artery of Percheron ﬊, is shown (R), in which a

single large perforating artery

from P1 supplies bilateral

thalami and the medial

midbrain. (Right) Axial FLAIR

MR shows hyperintensity in

the bilateral medial thalami

﬇ related to an acute artery

of Percheron infarct.

Extension to the medial

midbrain is often present.

(Left) Axial DWI MR shows

hyperintensity related to

acute ischemia in the posterior

limb of the internal capsule ﬇

in an anterior choroidal artery

distribution. The anterior

choroidal artery typically

supplies the lateral midbrain,

uncus, thalamus, posterior

limb of internal capsule, and

the optic tract. The posterior

choroidal artery typically

supplies the pulvinar,

thalamus, medial temporal

lobe, splenium, and choroid

plexus. (Right) Axial CT shows

a classic thalamic hypertensive

hemorrhage ﬇, the 2nd most

common cause of stroke.

(Left) Axial CT shows bilateral

thalamic hemorrhage

﬈

related to deep venous

thrombosis. Venous

thrombosis risk factors include

pregnancy, trauma,

dehydration, infection, oral

contraceptives,

coagulopathies, malignancies,

collagen vascular diseases,

and protein C and S

deficiencies. (Right) Axial SWI

MR in an elderly patient shows

extensive susceptibility

artifact-related

microhemorrhages

﬊ in the

bilateral hemispheres. Pattern

is typical of cerebral amyloid

angiopathy.

Brain: Pathology-Based Diagnoses: Malformations,

Trauma, and Stroke

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