Bilateral thalamic infarction due to artery of percheron occlusion with corresponding CT perfusion abnormalities
Bibliographic record
Abstract
Background: The Artery of Percheron (AOP) is a rare anatomic variant that supplies the bilateral medial thalami from a common origin; occlusion results in a characteristic pattern of bilateral thalamic infarction seen on neuroimaging. To date, we have not identified any cases in the literature describing corresponding ischemic changes seen on hyperacute CT Perfusion imaging. We aimed to characterize perfusion abnormalities seen in AOP occlusion by describing a case presentation, highlighting the importance of recognizing this syndrome clinically, and radiologically, in an acute stroke presentation. Methods: Description of a case, and literature search on PubMed. Results: A 74-year-old man was seen in the ER as a Code Stroke protocol with acute alteration of level of consciousness (LOC). ER assessment showed no focal abnormalities and was significant only for disorientation. CT/CTA/CTP initially appeared unremarkable for acute abnormalities. His LOC deteriorated requiring intubation, and subsequent MRI showed bilateral thalamic infarction. Further CT Perfusion review demonstrated increased Mean Transit Time and decreased Blood Flow without Volume abnormalities in the bilateral paramedian thalami. Conclusion: AOP infarction is an uncommon cause of bilateral thalamic infarction. We have demonstrated a case highlighting perfusion abnormalities not previously reported in AOP occlusion, illustrating the importance and utility of advanced CT perfusion imaging whilst considering less common stroke syndromes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.004 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".