Redefining Thalamic Vascularization Vicariously Through Gerald Percheron: A Historical Vignette

Gerard Percheron, M.D., a practicing neurologist and prolific researcher at the Institute Nationale de la Sante et de la Recherche Medicale (INSERM), made significant and valuable contributions to medicine, in particular, to the vascular anatomy of the basal ganglia. His particular interest in the thalamus eventually led to the identification of an anatomic variation in its vascular supply. This newly identified artery was subsequently named the artery of Percheron (AOP). Given the estimated prevalence of the AOP in up to one third of the population and its significant proportion of all thalamic infarcts, it is necessary for physicians to be aware of this anatomic vascular variant and its clinical consequences. Although occlusion of the AOP may present similar to other arterial thalamic occlusions, it can be identified through susceptibility-weighted imaging and ruled out with conventional or magnetic resonance angiography. Occlusion of the AOP typically causes a simultaneous and symmetric infarction. Treatment efficacy is time-dependent and necessitates thrombolytics and anticoagulative medications. Here, we trace a course from the artery's initial description in 1973 to its current implications in cerebrovascular stroke, and offer a synopsis of the proposed treatment.