Atypical Percheron Syndrome Secondary to HIV Vasculitis and Drug Therapy
Author(s): Lourdes de Fatima Ibanez Valdes, Humberto Foyaca Sibat*
Abstract
Introduction: The Artery of Percheron (AOP) is a solitary, rare artery arising from a proximal segment of the posterior cerebral artery, supplying both paramedian thalami and rostral midbrain. 4-12% of the population are reported to have this variant. Infarction of this artery leads to presentations including coma, gaze palsies, agitation and confusion. The AOP infarction is a relatively infrequent vascular condition and a pattern of IS in which a single arterial trunk supplies the rostral midbrain and paramedian thalamic areas, resulting in neurological deficits.
Methods: A large search of the articles published in SCOPUS, and MEDLINE to identify manuscripts related to midbrain ischemic stroke related to HIV vasculitis. From 01st, January 1990 to 30th, January 2026, we comprehensively review the medical literature and selected the following issues: “Artery of Percheron” OR “Percheron syndrome” OR “HIV vasculitis” OR “Midbrain stroke” OR “Weber syndrome” OR “HIV-atherosclerosis” OR “Pathophysiology of occlusion/reperfusion”, OR “Pathophysiologic of midbrain stroke” OR “Thalamic-mesencephalic stroke” OR “Drug management of midbrain stroke”.
Results: After searching medical publications, 407 articles were retrieved. We removed 291 duplicated titles and abstracts; 116 manuscripts are chosen. After assessing the inclusion/exclusion related to HIV-vasculitis midbrain stroke, Percheron syndrome due to HIV-vasculitis and pathogenesis of reperfusion criteria all publications were removed; finally, cero articles investigated the pathogenesis of occlusion and reperfusion of ischemic thalamic-mesencephalic IS secondary to HIV vasculitis.
Conclusions: To our knowledge, this is the first patient presenting with unilateral TMS HIV vasculitis-related due to partial occlusion of AOP branches with bilateral Babinski signs, and without complete thalamic manifestations reported in the medical literature. In young patients presenting with unilateral TMS, HIV vasculitis is one of the etiological diagnoses to be considered. Still, we recommend an extensive investigation based on a series of cases to support this postulate. As far as we know, this is the first study that graphically represent the elements involved in the pathogenesis of midbrain stroke secondary to HIV vasculitis and its mechanism of reperfusion at the rostral midbrain.